Guaranteed Right of Issue
Yes, every American that becomes eligible for Part B Medicare and is at least 65 years old has this extremely important and seldom mentioned guaranteed right for a limited time.
The catch is you only have this right for six months if you don’t choose any coverage other than Medicare Part A and B or twelve months if you choose privately managed healthcare called Medicare Advantage (Part C).
What does this mean to you?
It means at any time past the end of those two periods of time, you will lose this right. What is seldom explained is this right can save you tens or hundreds of thousands of dollars should your health decline and your need for medical care rises exponentially.
While no healthy person wishes to imagine the worst, it is a fact that ninety percent of American’s will suffer at least one chronic illness in their golden years.
At that unfortunate time in your life, you will experience high medical costs. When that happens, most people will seek other plans to save money.
Unfortunately, you will learn what you were never told about or were quickly convinced was inferior to Medicare Advantage. An insurance policy a Medicare Supplement plan (also known as Medigap coverage).
Should you become seriously or chronically ill in all states other than NY, MA, and CT, you will not be able to return to Medicare and buy a Medicare Supplement policy if you answer yes to any of the medical questions on the application. Your application will be automatically denied and there is no means to appeal the decision.
You will be stuck paying the high coinsurance and out-of-pocket costs potetially up to the maximum out-of-pocket (MOOP) offered by your Medicare Advantage plan, every year for the rest of your life.
We hear constantly about the lack of a maximum out-of-pocket (MOOP) limit for original Medicare and the wonders of having an MOOP for Medicare Advantage.
The Medicare Advantage MOOP for 2025 is $9,300.00 in-network and $14,000.00 out of network. Please check the plan you have or are interested in.
I can’t speak for everyone, but those amounts are insanely high and go up every year! The stated MOOP does not include any claims that are denied or the cost of any medications or the premiums you pay.
These MOOP’s defy logic because they are in no way inline with the intention of the founders of Medicare which was “to provide health coverage and increased financial security for older Americans who were not well served in an insurance market characterized by employment-linked group coverage.”
Imagine, getting cancer or having a heart attack, kidney failure or any chronic condition for the rest of your life and having to pay thousands of dollars more than was necessary each year because you were never told about your Guaranteed Right of Issue.
Medicare Advantage is a commercial product sold by private companies. The primary mission of a private business operation is to earn a good profit and provide their shareholders constant growth year after year – It is wealthcare, not healthcare.
Medicare Advantage is only a great product for those who are barely surviving on a very low income and cannot pay ANY monthly premium. It is certainly the lowest cost option for those who are never ill and intend to never get ill (which of course is rarely possible).
If you live in Washington and can afford a small monthly premium, I can show you a nearly invisible plan (because it pays almost zero commission to the agents) that will save you a great deal of money in your time of need.
My favorite plan is the one my wife, myself, my elder family frieds and clients enjoy. The premium is low and the maximum out-of-pocket is $2,870.00 (2025).
Now don’t forget, Medicare pays 80% of all of your bills, so to reach $2,870.00 out-of-pocket, you would need to have $14,350.00 or more in medical bills. You could have $250,000.00 in bills and your cost would be still be no more than $2,870.00. This is why we have insurance, not to get a $50 food card or a $10 gym membership!!!
Say you have a heart attack, get cancer, need a lot of imaging or complex surgery. You can rest knowing you won’t pay more than $2,870.00 out-of-pocket.
With Medicare Advantage, you face the MOOP of your plan plus any denials (which you pay 100% for and denials are much more likely with Medicare Advantage).
You will need a prescription drug plan to go with the supplement plan. You can see all the plans available to you on Medicare.gov.
My wife and I found a great prescription drug plan with $0 monthly premium. Please note that Medicare.gov is deceiving as the quoted cost of your actual medications can vary a lot from what they tell you because they don’t mention that those costs are “estimates.”
You don’t need an agent to sell you a drug plan. Just use Medicare.gov and enter all of your medications so you get instant quotes. Don’t base your decision on the premium, base it on your predicted drug cost. I have found some companies trick folks by using $0 or $2 premiums and then charge you much more for the drugs than they quoted. No insurance company is giving any profit away.
If you would like to learn more and you live in Washington, I will be happy to provide you with the same Medicare decision services that the luxury Medicare Concierge Services and Coaches charge $800.00 or more.
My price for a complete review of your situation is FREE! I will review all available plans on Medicare.gov with you.
I will also help you find the lowest cost drug plan based on your list of medications and I don’t sell any drug plans.
If you want to explore Medicare savings programs, I can review the eligibility criteria with you. If you have VA or Tricare coverage, I can help you too.
There is no obligation to enroll in a plan though me and it won’t add a penny to the cost of any plan or policy; but of course, if I earn your trust, I would hope that you would give me the honor of becoming your healthcare insurance agent.
Watch my informative videos at MedicareSelfHelp.com
Medicare Supplement Versus Medicare Advantage | Medicare Self Help LLC
Below is the legal disclaimer which I am required to post. However, I go further than posting the disclaimer; I will show you all the plans on Medicare.gov.
I do not sell all available plans. I am not with Medicare, no insurance agent or coach is.
If you can’t afford a small monthly premium today, you most certainly cannot afford high out-of-pocket costs when you get ill. Far too many people are sold on $0 premium Medicare Advantage and the insignificant ancillary benefits and learn the hard way later.
Please visit Medicare.gov or call 1-800-MEDICARE to get information on all of your options.” Then call me to learn the facts before choosing any plan.
