Many people would agree that the best hospitals in the world are in Chicago. But that doesn’t mean choosing health insurance is easy.
Ask Lori Lewis, an independent insurance agent in the Chicago area who was inspired to take on the role of health insurance expert after her husband contracted COVID-19 at the age of 55.
Lori acted as a patient advocate for her husband, who contracted the disease although he kept in good shape and had no pre-existing conditions. Her care of him led her to look into putting her newfound interest into a profession.
“I immersed myself in it,” Lori said of her insurance practice. “I’m passionate about it.”
Integrated Approach to Healthcare
Her husband is a chiropractor and both spouses have for a long time believed in preventative medicine – that is, living a healthy lifestyle and allowing people to coordinate their own care. They also believe in an integrated approach to healthcare, meaning that modern medicine should be given its due as well as preventative practices.
“Integrated medicine saved his life” Lori said of her husband.
Her husband required a long road of recovery, including 23 days on a ventilator. Thus she acquired many skills and knowledge of the twists and turns of getting good medical care as well as making sure insurance would fulfill its contractual agreement.
Health Insurance No Simple Thing
When people retire and no longer use their company health care plan, their options for Medicare are many.
“Once people turn 65 there are so many options” she explains. “Medicare Advantage Plans, or “Part C” plans, at one time were primarily HMO plans. Now they have expanded to PPOs and have many more options and much larger hospital and doctor networks.” She added that as carrier networks such as United Healthcare, Aetna and Humana expand in the state of Illinois, the plans will evolve to be competitive in the field.
Some of the major factors that go into choosing a health insurance plan is knowing whether one’s own doctor is in their plan, if they choose a Medicare Advantage plan versus a Medicare Supplement. Also important is finding a suitable hospital for one’s particular ailments, and making sure that one’s medications are on the formularies, or lists of covered drugs.
Every year or two Medicare recipients should reassess their Medicare Supplement plan or Medicare Advantage plan, the Palatine resident said.
It’s good to have an agent with whom you have a good relationship,” Lori said. This helps in that the agent can go to bat for the client if a claim is denied or another problem comes up.
How Does a Medicare Agent Get Paid?
There is a misconception that a Medicare patient can avoid the cost of the middleman if they enroll through a call center or online. But this is not true. All Medicare agents are compensated by the insurance companies themselves. Thus, the cost is the same whether you go directly to the insurance company or through an agent.
“I have no incentive to steer you in a plan that is $0 per month versus one that is $100 or more,” Lori said. “Independent broker agents get reimbursed the same amount as captive agents,” she added, referring to those who work for only one company.
“I think that many people are hesitant to speak with a broker agent because they think there are out of pocket costs involved. But there aren’t – if you go with me the cost will be exactly the same.”
Lori will offer you a needs analysis at no cost. Call her at 847-962-0951, email her at lori@seniorbenefitschicagoland.com, or visit Lori’s Senior Benefits Facebook Chicagoland page at https://www.facebook.com/seniorhelpchicago/