Medicare: For Best Results, Meet with an Agent
Kristan Dael
While many people are skilled and comfortable researching or “learning by googling” about various matters, when it comes to Medicare, you can’t beat hearing directly from an expert. Not only is help from an agent always free, but it can also help save substantial money, time, and stress.
In line with this, 50plus recently spoke with Larry Clemons, Devoted Health’s Sales Director for Oregon and Washington. Previously with another healthcare system, Larry joined Devoted after hearing about his aunt’s experience with the company shortly after it came to the market (in Florida) in 2019.
Q
When meeting with a new client, what is important for you to know about them, and for them to know about you?
A
The first step is to sit down and determine whether Devoted is a fit for you. You have the option to work with multiple carriers, and we truly do things different here. A lot of it is customer service — your call will be answered promptly, by someone in the US.
Once we’ve determined we’re a good fit, we can then move to top questions of need. What are you looking to change? What do you like about your existing coverage? What do you dislike? We listen to these things to best understand the needs of each person.
One important need to address is alignment with a carrier. You have the benefits you need, and the need to be able to use them with ease. For example, you need flexible benefits for dental coverage, over the counter (OTC) products, perhaps even groceries.
We work to ensure you have competitive copays — that when you go to the doctor you’re not paying an arm and a leg for specialists.
A big need is Part D, or prescription medication (Rx) coverage. This year there’s been a major change with this, including a new $2000 cap, deductible amounts, and out-of-pocket costs.
A lot of brokers have spent time going over formularies (tiered Rx plans). Part D hasn’t been changed in many years; the changes for ’25 have put pressure on some carriers, which resulted in them offsetting reductions in cost to consumers by limiting or cutting ancillary benefits they offer, such as dental, acupuncture and others.
To draw a simple picture of what all this means: Say, in the past, dental coverage may have been $3000, but because of Part D changes, dental coverage in that very same plan may have been reduced to $1000 in coverage.
Q
Do you feel it’s important for folks to review their coverage each year?
A
Absolutely. And not only should every consumer get a review each year, in a perfect world they don’t have just a carrier, but an agent they can turn to year after year.
The reason for this is it provides one person who understands your providers, who’s in or out of network, your medication needs, any health or lifestyle changes year to year, and so on. Not only is your dedicated agent going to understand changes in Medicare coming down the pike that may better serve you, but they also know you, and changes that may be going on with you. This enables them to take these two parts of the puzzle and put them together in a way that best benefits you.
About Devoted Health
Established in 2017, Devoted was created by two gentlemen who previously owned and then sold Athena Medicare. Considering their next venture, they were passionate about creating a company — a “revolution” they called it — that changed how healthcare was provided to seniors.
“They said, ‘Let’s build this as if it were for our own mom and dad,’” Larry recalls.
Hallmarks of the company include providing consumers with an experience. “When someone calls in, they’re speaking with someone in the US within 30 seconds,” Larry says. “And this person is going to be concerned and invested in the caller from the beginning.”
“For example, let’s say a caller talks about their poodle having to go on a special diet.” When they next speak, the agent will very likely think to ask, ‘Hey, how did your dog adjust to that new diet?’ ”
“Devoted has a different dynamic. We want to understand our members so we can walk with them when they experience any problems or troubles.”
Another unique aspect of the Devoted dynamic, Larry says, is its commitment to focusing on the person. “Getting established with a new doctor can take three to six months. In the meantime, if a refill is needed, that might mean having to go to the ER or urgent care — for a refill.”
“At Devoted, we work in partnership with doctors and nurses to ensure a continuum of care is in place. By getting those refills without necessitating a visit to the ER or urgent care, we’ve saved the time for the member and unnecessary overhead for the company. The latter can then be invested in providing the best possible services.”
Further, Devoted Health is committed to helping its members improve lifestyle toward better health and reduced need for medications. Larry says within three months, members often“flip their levels.” For example, with a patient who came in taking a dozen or more medications it was determined that one of those meds was causing a condition which required — you guessed it: additional meds.
“One of the greatest biproducts of our commitment to helping our clients achieve better health through lifestyle is hope,” Larry says.
“When you look at health from a different perspective, you begin to understand that diet, exercise — and possibly adjusting or reducing certain medications — can really make a difference. This leads to greater confidence, hope, and heath.”
“This company was started to do something to help seniors with healthcare. Part of that is helping them discover they can live a healthier life. We just do it differently.”