The Tragic Story of Choosing the Wrong Medicare Supplement
Once upon a time a couple turning 65 trusted their insurance agent to enroll them on a Medicare supplement. The agent signed them up on the one insurance company with which he was contracted to sell supplements. The company offered low premiums on its supplements, and it had a name that the couple recognized. So, the agent sold them each a Medicare supplement with that company.

But this is not the kind of once-upon-a-time story where the couple lives happily ever after. Although the supplements worked well when they saw their doctors—and paid well on medical tests they had run—six months after their supplements went into effect, the couple received their first rate increase. And it seemed like a hefty one—12%!

Although they were startled by such a rate increase—and so soon after buying the supplements—they said to each other, “Well, this must be the way it works with supplements. After all, aren’t all Medicare insurance companies the same?”

Yet, these increases kept coming—every six months. When added together, these increases averaged 20-25% per year! Was everyone experiencing this kind of rate increase?! And if this pattern of rate increases were to continue on their fixed income, how would they be able to afford their premiums in ten years?!

READ ALSO: Medicare Supplement Premiums Out of Control? What You Can Do About It

After three years, they decided that something needed to be done about their situation. They remembered the agent telling them when they signed up for these supplements: “This is a good company, so there is nothing to worry about. And, after all, you can change your supplements at any time.” So, they called their agent. They didn’t reach him, so they left a message.

Weeks later, after not hearing from him, they called the insurance company that carried their supplements. When they asked about their agent, they were told he was no longer contracted with that company.

So, where to turn? They talked to friends who referred them to an agent they used; and they called that agent. They explained their situation to their friends’ agent who, in turn, asked them some questions about their health.

In response they asked, “Why do you ask about our health?” “Because,” he explained, “after you move out of your introductory open enrollment period, you can only change to another supplement or to another supplement company if you are able to health qualify. The introductory open enrollment period for a supplement typically ends six months after your Medicare Part B goes into effect.”

They were shocked! But our agent told us we could change supplements at any time!” “Well,” responded their friends’ agent, “You can change anytime you can health qualify. So, let’s see if you can qualify.”

READ ALSO: Changing Your Medicare Supplement Can Save You Money: Here’s How

When he found out that the husband was diabetic with a history of heart issues, he shook his head. “I’m sorry,” he said, “I won’t be able to find a company, at this time, that will take you.” Upon learning that the wife had COPD and was taking three different blood pressure medications to try to control her high blood pressure, he gave the same response to her. “I am so sorry! I would love to help; I just can’t. The only option we currently have of reducing your premiums is to look at a Medicare Advantage Plan in the fall—between October 15 and December 7. As long as you don’t have End-Stage Renal Disease, your health won’t be an issue for enrolling on an Advantage Plan. Just keep in mind that Advantage Plans work very differently from supplements.”

The couple was shocked and disappointed. They loved how their supplement worked, especially the fact they could use any doctor [only 2% of seniors have reported difficulty finding a doctor who took Medicare] or hospital that works with Medicare—without having to get a referral. In addition, they have loved the financial protection their supplements had given them, as they had little or no out-of-pocket expense on their medical claims. [This, of course, depends on the kind of supplement one gets.]

The couple felt even worse when they learned from their friends’ agent that not all insurance companies have the kind of rate increases that their insurance company had doled out to them. Some companies only raise rates every twelve months, instead of the six-month increase they had been receiving from their company; and, of those, some have had a rate history of single digits (well under 10%), rather than the 20-25% increases they had experience on an annual basis. If only they had talked to this agent first!

There is a moral to this story: Not all supplement companies are created equal. Find a trusted insurance agent who is experienced with Medicare coverage and who is independent—preferably, one who represents many different insurance companies. If you do, you can inquire about the history of rate increases different insurance companies have had on their supplements. While no one can predict the future, a reliable, experienced, independent agent can give you wise guidance based on past performance. As a result, there is a greater likelihood that you will continue to enjoy the benefits of your supplement for years, while affording the premiums of that supplement.


Shari BrockShari Brock
22:12 18 Apr 24
John sat down with both of us and explained everything and answered any questions we had. He researched for the best plans for us. Highly recommend!!
Eric GuvernatorEric Guvernator
03:16 16 Apr 24
With all the endless solicitations I had received as I approached my 65th birthday, I had never expected to feel so comfortable and relieved to have John guide me seamlessly through the process. I couldn’t have asked for a finer experience. Not really having a clue going into our meeting, I left having confidence that I was gifted with the perfect plan as well as an advocate in my corner.I continue to get timely explanations and guidance anytime I send a question on Medicare material.If like me you are approaching this monumental deadline, contact John and let him handle this important process. You will not be disappointed.
Judi CarrollJudi Carroll
23:28 15 Apr 24
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Lynn SmithLynn Smith
20:41 15 Apr 24
The change to Medicare and supplemental health insurance can be terrifying. John Claeys and The Claeys Group Insurance Services made the process unbelievably simple. John is incredibly knowledgeable and up to date on all of the latest requirements. He explained the process and my options in a very simple and concise way and easily helped guide me in making the best decision for my situation. I cannot imagine navigating this medicare system without him. I also feel confident that he will safeguard and watch my situation in the event of future changes. Knowing that he is watching out for me going forward is the best part of all!
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18:06 15 Apr 24
John Claeys has been very thorough with every detail of this important decision for me and my future Healthcare. He has such a sweet and caring spirit. I can't imagine using anyone else for my insurance needs.
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15:26 10 Apr 24
John was very helpful explaining different Medicare options
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13:50 08 Apr 24
Excellent customer service. Professional and knowledgeable. Received what I needed and wanted at a reasonable price.
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23:05 05 Apr 24
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Rosa MartinRosa Martin
21:53 05 Apr 24
John is a very knowledgeable person in his profession. He has helped my husband, my sister, and myself to find the best affordable insurance for each of us…He made navigating through Medicare a breeze for me. He is willing to help in any way and any time of the day.Thank you John for all your help.
Johnny CoffmanJohnny Coffman
16:33 05 Apr 24
He explained the ins and outs of how Medicare works and clarified the confusion. Highly recommend John Claeys!
Mark BleuerMark Bleuer
22:48 03 Apr 24
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sheila Rhynesheila Rhyne
14:58 03 Apr 24
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Scott GillScott Gill
00:34 03 Apr 24
Highly professional with attention to detail. Felt like John was genuinely interested in matching my needs to the various options.
Karen DeemKaren Deem
21:02 02 Apr 24
John was very pleasant and professional. Medicare can be very confusing. He had all the answers for me.
Beth HamillBeth Hamill
17:52 02 Apr 24
I am so thankful for John's help and kindness...he explains everything so clearly and I feel confident that he is truthful and finding the best plan for me.
Margie FisherMargie Fisher
22:38 13 Feb 24
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Jerry JonesJerry Jones
02:27 08 Feb 24
John was very helpful in guiding me through the medicare choices. He explained everything thoroughly and answered all my questions.
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23:31 07 Feb 24
Tonda SammonsTonda Sammons
21:26 07 Feb 24
Judy CraftonJudy Crafton
20:54 07 Feb 24
Mr. Claesy, was a pleasure to work with on just a short time table, my not paying attention to dates for Medicare changes! We really appreciated his response and meeting personally with us. We highly recommend him for your insurance needs. Thanks again for doing a wonderful service.
Dannie SkipperDannie Skipper
20:50 07 Feb 24
John was very helpful in selecting insurance companies for Roy. He demonstrated that he was very knowledgeable about what was available and what was needed. He made recommendations, provided details, and gave good advice to us. He was flexible and did what we asked of him to complete the process of selecting the best insurance companies for the situation. We are grateful for his help and pleased with the results.
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