Turning age 65 is quite a milestone. If you are fortunate enough to reach this point in life, you are most likely looking at retirement and considering Medicare options. When people turn 65 and have worked for at least 10 years, they automatically qualify to enroll in Medicare once they retire and plan on taking their social security. Soon after enrolling, they will receive their red, white, and blue Medicare card in the mail.  The basic government Medicare offers: Part A, which covers anything hospital related. Most people who have had 10+ years of working experience, are eligible to get this for free. If you don’t qualify for Part A, this can be very expensive. Then, there’s Part B; this covers doctor’s visits, outpatient services, testing, etc., and most people will pay $170 for their monthly premium for 2022, which comes out of their social security. If you are not on social security, you will be billed this amount.

Medicare covers 80 percent of medical costs, whether you go to the hospital or visit your doctor’s office. As a Medicare recipient, you are responsible for the remaining 20 percent, as well as the deductible. The deductibles are set by CMS (Center for Medicare and Medicaid Services). This varies and tends to go up a little every year. As long as you find a physician that takes Medicare, and the services provided are covered by Medicare, it will provide 80 percent coverage, and you are responsible for meeting the deductibles, and paying the remaining 20 percent.

If you delay getting your social security and continue working beyond the age of 65, once you do retire, you will have to enroll yourself. This can be done online at www.SocialSecurity.gov, calling Social Security at 1-800-772-1213, or visiting your local social security office.

Prior to using your original Part B Medicare at the doctor’s office, you must meet a $233 deductible for 2022, before it starts paying the 80 percent, and you will still be responsible for the 20 percent. The same applies for the Part A hospital deductible which is $1556 for 2022.

In the United States, at age 65, people retiring are automatically eligible to receive Medicare, which is a government provided health coverage, but, because this is often not enough to cover all medical expenses, people often opt to get additional coverage from independent healthcare providers, such as United Healthcare.

Lauri Wenzel is a local, Licensed Sales Agent with United Healthcare Medicare Solutions. Her goal is to educate people about their healthcare options. “I try to get to know my members so that I understand what their needs are, and offer them the best options to suit their budget.” Lauri is now a Silver Premier Producer, which mean she serves over 100 members. United Healthcare Medical Solutions offers some of the best option plans. They are one of the largest companies providing Medicare Health coverage, and have a great reputation. They are the only insurance company endorsed by AARP.

As a result of COVID, United Healthcare found ways to improve the way they do business with their members. Today, much of Lauri’s business is handled through her home office, where she conducts phone interviews and schedules her appointments. She also meets her clients via Zoom or home visits. “I come to you,” said Lauri. “I’ll meet my members wherever it’s convenient for them.” Prior to COVID, Lauri had an office in Conroe, but late in the summer of 2021, she had to let it go since most people still didn’t feel comfortable with meeting face-to-face. “I found out I wasn’t actually using the office space for interviews as often as I thought I was,” she said. Now, Lauri uses the following mailing address for correspondence: 8000 Research Forest Drive Suite 115-195, The Woodlands, TX 77382.

“United Healthcare also added an online system that helps us get signatures,” said Lauri. “We can send members an Adobe Signature document, similar to those used when you purchase a new home. This facilitates enrollments done via email. It’s encrypted and safe. We can also do this through a text message. You can answer security questions to get authorization to sign the document. We can complete verbal applications with voice signatures using a recording with United Healthcare. This is convenient when someone doesn’t have a computer or phone.  Basically, I do the whole application with them verbally, and they give verbal approval. They’ve made all these options available, to make it easier for our members to enroll.” Previously, if you were going to complete an enrollment, or signup for a Medicare plan, on the phone, you would call tele-salespeople, and you would probably speak to someone anywhere in the world, and would likely never get the same person on the phone again.

“Now, local agents within the community are able to add that personal touch and always be available for our current and new members, stated Laurie. “They can call me directly, and I may not have the answer to all of their questions, but if that’s the case, I can direct them to the right person.”  According to Lauri, it is convenient and beneficial to members to have access to their local agents at any time they have questions.

United Healthcare has always had HMO options (in network) and PPO options (out of network), but plans and benefits are always changing. There have seen some improvements in over-the-counter benefits, copays for outpatient surgeries, as well as hospital stays. United also offers Dual Medicare Advantage Plans. For people who are on Medicare and Medicaid, they get funds to spend monthly on over-the-counter items. For example, they can go to Walmart or go online and get food items, or OTC medicines or health supplies monthly, and that has been a really good benefit for people on dual plans.  This is why people look to private insurance companies such as United Healthcare to provide more coverage.

Original Medicare does not cover prescriptions, but it can regulate the prices of drugs, even if it’s bought through an independent outside source. This option is Part D, Prescription Drug Plan.

Through United Healthcare, members can choose from the following:

Option 1 – AARP Medicare Supplement Plan G (supplements the original government Medicare).

This option helps pay for some of the out-of-pocket costs, not covered by the original Medicare Parts A and B–although you will pay a higher monthly premium of at least $150, which will likely go up yearly. This plan basically pays for the “gap” (commonly referred to as the “Medigap”) which is that 20 percent, but you still have to meet that Part B deductible. Along with Option 1, you also have to pay for a Part D Medicare Prescription Drug plan with a monthly premium of approximately $35. With Option 1, you pay whether you use it or not.

Option 2 – Medicare Advantage Plan Part C provides several options.

By law, it has to cover at least as much as the original Medicare, but it always includes more. This plan is beneficial to members when they consider their deductibles. With this plan, you pay as you go, or only when it is used.

• HMO plans – in network with certain doctors and hospitals is zero premium. Will include Part D Prescription Coverage. You’ll still pay co-pay prices for prescriptions, but with hospitals and doctors, you’ll also pay co-pay prices or co-insurance. On an HMO plan, once you hit the maximum amount, Medicare Advantage will cover 100 percent. This means that with this option, your private insurance, United Healthcare, is managing your Medicare for you.
• Another perk is that it usually includes extras like fitness membership, dental, vision and hearing care. This is the most popular plan because it is more affordable. It provides good coverage, and it offers more than with the original Medicare…plus the perks!
  
  It is important to remember that when you turn 65 and want a Medicare Supplement like Plan G, you only have a 6-month window to enroll without any questions asked.
  
  People can choose to delay Part B, and when they enroll later (usually after they retire), they also get that 6-month window to enroll in a Medicare Supplement like Plan G. If you go past the 6-months, you will have to answer health questions in order to get approved. Waiting may result in paying higher premiums or getting denied altogether, because at this point, you may be considered more of a risk.
  
  Lauri continues to choose the Multiple Myeloma Research Foundation as her charity of choice www.theMMRF.org and makes regular donations. When she’s not working, Lauri loves to spend time with her family. They enjoy going on bike rides, hikes, or day trips. They also like supporting local restaurants and going to the movies.
  
  Currently, Lauri serves members that span from Huntsville, Conroe, and the Livingston areas. According to Lauri, she likes to treat her members like family, “Choosing the right coverage can be overwhelming, and I want to make sure they feel good about the choices they make.”
  
  For questions about your healthcare options, contact Lauri via Email: l.wenzel.uhc@gmail.com, or by phone: 832.244.1973.