Forgive me if this sounds like common sense, but nobody can have it all, no matter how much money or how many resources you have. There are opportunity costs for everybody. To have one thing, you are giving up many others.
For example, you can’t be a workaholic and expect to be a phenomenal family man or Mom-Of-The-Year. If you wanted to read 100 books this year AND be in the best shape of your life, it might mean you have to not be able to run a brand new, start-up business, which is usually very time intensive.
Every one of us has to pick-and-chose what to focus on and what’s important to us. I’m not saying don’t try to maximize your potential and be the best version of yourself, whatever-that-may-be. The simple, unavoidable fact is we are all limited to the same one body and 24 hours in-a-day. We all must make choices at the expense of other things, like-it-or-not.
How then, does this apply to insurance? And in my client’s case, Medicare insurance specifically? Not long ago I received a call from a lady who said, “I was talking to my sister and she has one of those zero premium deals and that sounds good. I’m paying two hundred bucks a month and it’s knocking me in the creek! (This was her actual phrase, which I thought was great) I also want a plan where I don’t have any co-pays, I can go to any doctor and my drug plan is included. And do they have one where it has extra stuff like gym memberships, dental and vision coverage too?”
Luckily this lady’s example is rare, as in ten years of doing this I’d never had someone sound so entitled and out-of-touch with how insurance works. I asked her if she was on Medicaid and well as Medicare, as I could help her get what she was looking for better if she did. She wasn’t. She had Original Medicare and was paying the $200 bucks for a Medicare Supplement and another $45 for a stand-alone Part D Prescription Drug Plan.
So back to the original point, I explained that there were two basic ways of getting Medicare coverage (to see that broken down click here). There were opportunity costs for either one. In essence, if she wanted the freedom of what she already had, of no-co-pays and the ability to see anybody who’d see Medicare patients she was going to have to pay a premium (literally and figuratively).
If she was looking to not pay a premium, she was going to have to deal with the uncertainty of co-pays and having a network of doctors, which I could see if her doctors were participating in. On the plus side, she’d get a host of extra benefits she wasn’t getting now. But no plan existed that met all her imaginary criteria. After I explained to her the basic differences between the two options, she had more realistic expectations of what to expect and also got to decide which approach would be better for her.
After our discussion she weighed both her options and made an informed decision of what path she thought was better for her. She decided she would get a Medicare Advantage plan and we got her on the best one for her situation. But because she understood everything, she was able to feel good about her choice and have full disclosure of not only what she had, but also what she was giving up. Which made her appreciate what she now had, and I’d like to think, make her realize even with Medicare, we can’t have our proverbial cake and eat-it-too. Just like life 😊.
