Making Sense of Medicare

Making Sense of Medicare

By Alison Bailin Batz

Opening any new business has its challenges.
Connie Health isn’t immune to that. Michael Scopa founded the health care venture with business partners David Luna and Oded Eran without knowing COVID-19 was on the horizon.

“As you can imagine, businesses opening right now, like ours, are facing some of the most unique challenges of our time,” Scopa says. “Certainly, we are opening Connie Health at a precarious time, but it will take more than a global pandemic to keep us from our mission.”

Launched in August—primarily online in the short term—Connie Health is named in honor of Scopa’s grandmother, Connie Francis, and is focused on empowering local seniors to make confident, worry-free decisions around Medicare plans and coverage.

“People of all ages, but especially those approaching 65, shudder at the mere mention of Medicare, which is a government-run medical insurance program for those age 65 and older or people at any age with disabilities,” Scopa says. “It is overly complicated for no good reason, and we are out to change that.”
Scopa, Eran and Luna have more than 25 years of combined experience helping people navigate what sometimes feels like the minefield that is Medicare coverage.

“What we have found is that there were two ways individuals were securing their Medicare coverage,” Eran says. “The first is through technology, meaning finding a provider through a general internet search and then dealing with one of its call center employees, each of whom is tasked to sell certain products.”
The other, according to Eran, is through a local adviser, with whom they already know or have found through a referral. Both methods have their benefits and their drawbacks.

“The big companies with millions of marketing dollars also have massive infrastructure and technological capabilities, meaning they have information at their fingertips with the stroke of a key, but they are often solely focused on selling a few specific plans,” Eran says. “The licensed, local advisers offer that personal connection but often don’t have the resources to truly access more than a handful of products.”
A former Glendale police officer, Luna was one of those advisers in the Valley, eventually working on the regional and national level because he understood what people needed and wanted, as well as his willingness to guide folks along the way.

“I got to a point in my career where I believed very strongly that you shouldn’t have to choose between working with a licensed adviser who knows the details of plans in your area or using a powerful digital tool,” says Luna, who is also a military veteran. “Connie Health is truly a marriage of both.”

Connie Health provides these services at no cost. “As a licensed advisor, we are compensated by the insurance companies when someone joins,” Luna says. “The maximum compensation an insurance company can provide is regulated by the Centers for Medicare and Medicaid Services (CMS).” Unlike other industries, Connie Health recommends plans solely based on an individual’s needs.

Due to its choice to affiliate with all major providers, Connie Health can use its technology to advise individuals—either in person from a safe distance, on a video call, via phone or otherwise—about the best options based on personal health care needs, lifestyle and budget. The team is also able to identify Medicare providers in the area, including those in Medicare Advantage HMO or PPO networks.

“We can also explain HMO and PPO and other unnecessarily complicated things when it comes to health care,” Oded says. “And, we can help find a plan that allows you to keep most or all of your current doctors.”
Beyond initial services, Connie Health also helps individuals handle the sometimes-tedious tasks of enrolling and will continue to serve as a resource for health care questions and decisions moving forward.
“There are ways to maximize your chosen plan, optimize prescription costs and uncover seemingly hidden benefits to plans such as annual wellness screenings, drug and alcohol counseling services, hearing tests, diabetes evaluations and more,” Scopa says.

Though the business will remain virtual for now, there are six licensed team members working locally, with plans to add more in 2021. Medicare’s open enrollment period is October 15 to December 7, meaning those approaching 65 or those with questions about their current plan can start seeking help right now.