Understanding Medicare might be better left to the professionals

Sheri Ulibarri says Medicare was the “last thing on Earth” she wanted to do.

“I said, ‘I will never touch Medicare because it’s so complex,’” said Ulibarri, a licensed insurance broker. “Then my mom got sick and she was getting all these obnoxious (Medicare) phone calls. I realized if my mom was getting them, everybody else was, too. I thought, I’ve got to help our community. I have to help people.”

Since then, Ulibarri, a certified senior advisor, a registered Social Security analyst and financial security navigator, has begun specializing in areas such as Medicare Advantage plans, Medicare supplemental plans and retirement planning.

“Now, I do probably 95 percent Medicare,” she said.

Medicare is a federally-funded health insurance for people 65 or older, but someone may be eligible for Medicare earlier if they have a disability, end-stage renal disease or ALS, more commonly known as Lou Gehrig’s disease.

Some people get Medicare automatically, while others have to actively sign up depending on if they start getting retirement or disability benefits from Social Security before they turn 65. Whichever situation a person finds themselves in, Ulibarri encourages them to connect with a broker like herself and become educated in all the aspects of the program.

“It’s a lot easier when you work with a broker. Sometimes you are working with Social Security and you can be on hold for hours. We can help mitigate some of that time concern,” she said. “Medicare is such a monster to navigate. When you have somebody who’s educated on it, it’s easier to find the gaps in their coverage. We don’t consider ourselves salesmen. (Brokers) consider ourselves problem solvers, solution finders and educators.”

Whether someone is enrolling in Medicare for the first time or already has a plan, Ulibarri says a broker can help them find the plan that best fits their needs and is up-to-date on yearly changes.

“We are required to take a course every year and pass a test with a 90 percent or better so we can help people navigate Medicare for the following year,” she said. “There’s always something that’s changing.”

Ulibarri and members of her team offer clients a comprehensive needs analysis to determine which plan best fits their needs.

“Everyone’s needs are different. We ask questions and find the plan that fits. Some people might need dental benefits while another needs transportation help,” she said. “The (Medicare) calls people receive are usually just one carrier and they say this is what we have, but it may not be what you need.”

With annual enrollment for Medicare just around the corner — from Oct. 15 to Dec. 7 — Ulibarri expects those phone calls to begin inundating the homes of seniors and encourages them to reach out to a broker.

During annual enrollment, someone can join, drop or switch to a Medicare Advantage Plan, switch between an advantage plan and original Medicare, or vice versa and change to another Medicare drug plan if on original Medicare.

Ulibarri said a client can make as many changes as they want during the annual enrollment period, but the options they have chosen become locked in for the next calendar year on Dec. 7. Coverage for advantage plans begin on Jan. 1 of each year.

There is a second enrollment period from Jan. 1 to March 31, but you can only switch to another advantage plan or return to original Medicare. Coverage starts on the first of the month after the plan gets your change request.

If you are already receiving Medicare, Ulibarri said it’s a good idea to review your plan annually and possibly see a broker for a needs analysis.

“As we get older, our needs change. A lot of the advantage plans have extra benefits, like over-the-counter cards that cover groceries or nonprescription medications,” she said. “Maybe you need more vision benefits. Our goal is to make sure we are finding the most cost effective plan for our clients. Make sure they have the lowest premiums, out-of-pocket maximum, co-pays. If you have a chronic condition, we want to make sure that plan is tailored to that need. There’s a lot to the Medicare puzzle. It’s important to me for our community to be healthy and know what they have.”

Brokers also cannot take any kind of compensation or gift from a client, she said, but they do receive a commission from the insurance carriers.

“For instance, if a new client comes to me and after I do the comprehensive needs analysis, I find the plan they are on is the one they need to stay on, then I don’t get any kind of compensation,” Ulibarri said. “And that’s perfectly fine. I’ve done my due diligence. I just ask them to refer their friends and family. I want to make sure my clients get what they deserve, and educate them on what they’re eligible for because we’ve all paid into this system for so many years. It’s what they’re entitled to.”

Ulibarri’s office, H & I Insurance, is located in Rio Communities. Appointments can be made by calling 505-639-5966.