Help Clients Navigate Common Medicare Pitfalls
Observation status doesn’t count. Advisors should inform clients about this rule and encourage them to verify their hospital status to avoid unexpected SNF costs. Olivia’s Medicare Advantage Relief Olivia had enrolled in a Medicare Advantage plan that featured a maximum out-of-pocket limit, or MOOP limit. This gave her peace of mind when her healthcare costs started rising, as she knew her out-of-pocket spending was capped for the year. Unlike Original Medicare, Medicare Advantage plans include an annual cap on out-of-pocket spending. Advisors should encourage clients to consider MOOP limits when selecting a plan, especially for those with anticipated higher healthcare needs. Roberto’s IRMAA Surprise As a high-income retiree, Roberto was surprised to discover that his Medicare premiums were higher than expected due to the income-related monthly adjustment amount, or IRMAA. This surcharge raised his Part B and Part D premiums based on his income from two years prior. Advisors should discuss IRMAA with high-income clients, helping them plan for the surcharge. Advisors can also assist clients with appealing IRMAA if their income drops significantly due to retirement or other qualifying events. Olivia and Roberto’s Travel Plans and Medicare’s Limited Coverage Abroad Both Olivia and Roberto had always dreamed of traveling...