How this new online tool could help you decide on Medicare coverage

“Ask Phil,” aims to help older Americans and their families by answering their health care and financial questions. Phil is the author of the book, “Get What’s Yours for Medicare,” and co-author of “Get What’s Yours: The Revised Secrets to Maxing Out Your Social Security.” Send your questions to Phil.

United Income, an online personal financial management and planning service, is launching a free Medicare Advice tool to help people determine the kind of Medicare coverage they should have. It’s worth a look and, in combination with other resources, can help reduce widespread confusion about how Medicare works.

The Centers for Medicare and Medicaid Services (CMS) recently released its own smartphone app that helps people understand what’s covered by original Medicare – Part A for hospital and nursing home coverage, and Part B for doctors, outpatient expenses and durable medical equipment.

The app explains what Medicare does and does not cover, but it does not provide any guidance about private Medicare insurance plans. These include Part D drug plans, Medicare Advantage plans and Medigap supplement plans.

The United Income tool provides recommendations on the best mix of these plans, based on user responses to a series of questions. It also includes estimates for premium costs. But it does not recommend any specific private health insurance plans or estimate out-of-pocket expenses for such plans.

However, armed with its general recommendations, a person could then use the CMS online Plan Finder tool to learn about the private plans available where they live, including their projected typical annual costs. Plan Finder also permits side-by-side comparisons of up to three plans at a time and includes information so people can contact the plan providers and find out more details.

Finding out what these tools recommend is not the end of the line. None of them can reproduce a person’s unique health, financial and lifestyle traits. In the end, those variables will drive many Medicare decisions.

Given the expense and importance of health care for retirees, however, United Income officials said it made sense to include Medicare support tools on their platform.

“A key part of financial planning involves government benefits,” senior vice president for operations Elizabeth Kelly said in a phone interview. “The average retiree spends $4,300 on out-of-pocket health expenses, and this total can be much higher at older ages.”

At the same time, Medicare is so complicated that company representatives said they thought it was important to design a sophisticated decision-making tool that was still easy for people to use and produced clear recommendations.

The interactive tool asks people specific questions about their health and insurance needs, applies Medicare’s often-complex rules to answer the questions and then produces an easily understood recommendation along with narratives explaining reasons for the recommendation.

Andrew Vincent, senior vice president of products, said the questions are detailed enough that the tool can produce accurate solutions, but it does not ask for sensitive personal information such as names and other identifying information, and the company does not share the information it collects with anyone else. Vincent also emphasized the company has no relationships with health insurers that might bias its advice.

The tool appears designed primarily for people who have not yet enrolled in Medicare. If you already have Medicare, however, you still might want to see if there is another mix of plans that would better fit your needs. You can use the tool to do this but when it asks if you already have insurance, click on “none” rather than Medicare.

While the tool can be helpful, it does have limitations.

For example, some of the toughest issues about making the move into Medicare involve decisions about how to deal with employer health plans. With more people continuing to work past the age of 65, Medicare choices increasingly are affected by issues of how employer plans work with Medicare. These matters are addressed by the United Income tool but providing accurate answers can involve doing some extra homework beforehand.

Users are asked, for example, these questions about their employer plan:

  • Can it remain my primary insurance past age 65?
  • Do I pay a premium for this insurance?
  • Does the plan include drug coverage at least as good as Medicare (Creditable Coverage)?
  • Will the plan drop me if I enroll in a Part D drug plan?
  • Do I contribute to a Health Savings Account?

The answers to these questions can play a major role in determining the best mix of Medicare plans a person should consider. However, based on the Ask Phil questions I receive, I doubt very many people can answer them.

These are good things to know even if you don’t use Medicare Advice, and can be provided by employer health plans.

Readers: If you try out this tool (or any service that helps with Medicare coverage decisions), please let me know about your experience.


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