Problem 1:
Most people sel ect their insurance plans and associated benefits by following the advice of a broker, their best friend’s experience, or gut feelings.
As a result, people end up under-insured, over-paying for meds, unable to afford care, and eating into their retirement savings.
50% of available benefits go unused
25% of older adults can’t afford meds
700K people go bankrupt yearly due to medical costs
Problem 2:
Brokers, financial planners, healthcare providers, and social workers lack personalized tools that provide precise benefits guidance, so their advice to beneficiaries may not meet their particular needs.
In these professions that often use legacy tools, where faxes remain the norm, piecing together siloed and disparate data is impossible.
If these professionals want to remain relevant, especially with 40m entering retirement over the next 10 years, they will need to advance fr om basic calculators to easy-to-use tools personalized for their customers.
There are thousands of plans to choose from, but what is most complicated is that the beneficiary is moving from one system - obtaining insurance from an employer - to a new system - obtaining insurance from the government. Additionally, Medicare is not one thing. It is a group of products that work together. These products have deadlines and penalties, and beneficiaries must navigate the system without the help of an HR department to help them make choices, while avoiding costly mistakes.
The first hurdle for the newly eligible beneficiary is understanding her or his eligibility date for enrollment. If they miss this period, they will face a lifetime penalty. At the same time, the beneficiary is trying to weigh various packages of health benefits to decide what is the best fit, considering any number of variables. One concrete example: if the beneficiary moves back to the US after living overseas, they have 63 days to get signed up for Medicare or they miss their eligibility window and face penalties. No one tells you this. Another example: If the beneficiary didn’t spend enough years in the workforce (maybe they were a stay-at-home parent, or were divorced and remarried before 60, they could possibly not be eligible for full Medicare if their spouse is under 65. The list of rules and
exceptions like these is long and convoluted. And for a critical healthcare and financial decision, there are tens of thousands of plans to choose from with little guidance or concrete best practices.
Selecting Medicare coverage is not as simple as choosing a plan. The beneficiary must find a package that provides appropriate and complete coverage, while considering cost, convenience, quality, and network. Studies report that 85% of people have the wrong coverage for their needs.
A few research reports that cover this complexity:
https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.15227
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194961/
https://www.thirdway.org/report/rethinking-medicare-enrollment-make-high-value-health-coverage-the-easy-choice
Trusty.care’s patent-pending technology took this baked-in complexity and built a model to help the beneficiary more simply navigate these variables, without risking missing a critical decision factor.