BEEKMANTOWN — Steve Criss meets his clients right at the kitchen table.
The 55-year-old insurance broker specializes in Medicare, helping North Country seniors find the right plan for their medical and financial needs, and prefers to work either out of his own West Chazy home or at that of his clients, who he refers to as his “people.”
“The seniors in our area really need people to help them,” Criss said. “A lot of people aren’t mobile and can’t get out to the local agencies. And, of course with the pandemic, everything is virtual now, but not everyone has a computer.
“I go and see them. I love meeting at the kitchen table.”
Criss, owner and operator Criss Consulting LLC., entered the insurance scene a decade ago after a career in sales.
Plattsburgh insurance agents Sara and Andre Bordeleau took him under their wings, teaching him the ins and outs of insurance.
“When I first started in this business,” Criss said, “I thought, ‘Oh my goodness. How do they expect people to understand this?’ It’s very confusing to people.”
He later chose to specialize in Medicare plans and earned his certifications for every carrier offered in the Clinton, Essex, Franklin and St. Lawrence counties.
“I do every plan, so I’m very unbiased,” he said. “I try to find my clients a plan that truly fits them and their needs.”
That’s a total of 37 different Medicare Advantage plans through eight different companies, including MVP Healthcare, WellCare, Empire Blue Cross Blue Shield, Aetna, CDPHP, United Healthcare, Fidelis Care and Excellus Blue Cross Blue Shield.
That was unlike the out-of-state brokers seen on television commercials, Criss noted.
The independent insurance agent all too often hears of seniors signing up for plans that are not accepted at prominent North Country health centers and offices.
“Then the person will call me back and say, ‘Hey Steve, I need to see you, because I signed up for a plan over the phone with someone from Texas and I can’t use it, because it’s not being accepted,'” he said.
“I’m from here; I know what plans work. That’s why it’s important to have an independent agent.”
‘HOW GOOD IT FEELS’
Ten years into the business and Criss has a client base of 500.
During open enrollment, which is from Friday, Oct. 15 to Tuesday, Dec. 7, he meets his clients to select a plan that best fits their medications lists, doctor visits, health conditions and financial status.
“You know how good it makes me feel to get out and help people who didn’t realize they could get help on their prescriptions when they were paying $300 for their insulin and trying to live off of $1,000 — it’s pretty gratifying,” he said.
“That’s why I started specializing in the senior market.”
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WHAT IS MEDICARE?
Medicare is a national health insurance program in the U.S., providing health insurance for people age 65 and older, as well as certain people with disabilities and those in final stages of renal (kidney) disease.
The Social Security Administration accepts applications. According to the New York Office of the Aging, apply during the period from three months before your 65th birthday month through three months after your birthday month to avoid penalties.
WHAT ARE THE PARTS OF MEDICARE?
The official U.S. government Medicare handbook “Medicare & You” of 2022 lists the following:
Part A (hospital insurance) helps cover:
• Inpatient care in hospitals
• Skilled nursing facility care
• Hospice care
• Home health care
Part B (medical insurance) helps cover:
• Services from doctors and other health care providers
• Outpatient care
• Home health care
• Durable medical equipment, like wheelchairs, walkers, hospital beds and other equipment
• Many preventive services, like screenings, shots or vaccines and yearly “wellness” visits
Part D (drug coverage) helps cover:
• Prescription drug costs, including many recommended shots or vaccines
Plans that offer Medicare Part D are run by private insurance companies that follow rules set by Medicare.
WHAT IS THE DIFFERENCE BETWEEN ORIGINAL MEDICARE AND MEDICARE ADVANTAGE?
According to the official U.S. government Medicare handbook “Medicare & You” of 2022, there are two main ways to get Medicare: Original Medicare or Medicare Advantage.
Original Medicare includes Part A (hospital insurance) and Part B (medical insurance), and is accepted at any doctor or hospital that accepts Medicare in the U.S.
Beneficiaries can join a separate drug plan to get prescription coverage, as well as purchase supplemental insurance coverage to help cover out-of-pocket costs.
Medicare Advantage, known also as Part C, is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for health and drug coverage.
According to the 2022 handbook, they typically include parts A, B and usually D; have lower out-of-pocket costs in comparison; and may offer extra benefit, like hearing, vision and dental. In most cases, beneficiaries will need to use doctors who are within the plan’s network.
WHAT IS MEDICARE’S TIME TABLE?
The official U.S. government Medicare handbook “Medicare & You” of 2022 suggests beneficiaries mark their calendars with the following dates:
• Friday, Oct. 1: Start comparing current coverage with other options. Visit Medicare.gov/plan-compare
• Friday, Oct. 15 to Tuesday, Dec. 7: The open enrollment period, also known as the window to join, switch or change Medicare coverage.
• Saturday, Jan. 1: New coverage begins alongside any changes to a beneficiaries’ pre-existing plan.
• Saturday, Jan. 1 to Thursday, March 31: The window to (only once) change to a different Medicare Advantage plan or switch to Original Medicare. Changes will be effective the first of the month following the plan’s receipt of the request.
For more Medicare information, visit medicare.gov