Important things to know about Annual Enrollment

Annual Enrollment Period, (AEP) also know as Open Enrollment Period (OEP) is from October 15, 2015 until December 7, 2015.

  • All Medicare Advantage Plans and all Prescription Drug plans will change for 2016.  Medicare supplements (Medigap) benefits will stay the same and automatically renew.
  • It is important to “shop” for a plan for 2016.  This can be done at www.Medicare.gov or by contacting a reputable insurance agent that represents numerous plans.
  • Your existing insurance plan is required to let you know by letter what changes will be made for 2016.
  • If you are satisfied with your existing coverage, it will automatically renew for 2016.
  • If you want to change plans, this OEP is the time to make the change.
  • Part B premiums will be going up for new Medicare beneficiaries.  This will not affect existing Medicare recipients.

 

Don’t Miss Medicare Annual Enrollment Period

Beginning October 1, 2014 Medicare eligible beneficiaries can start “shopping” for new Medicare Advantage and Medicare Part D Prescription Drug Plans (PDP).   Those who are in Medicare Supplement plans should be okay unless you have seen major rate increases and want to see if you can get a better premium price.

I highly recommend at least looking at the options available to you.  I have seen clients save up to $2000 per year by just changing to the best prescription plan for them.  The Part D plans are annual contracts and can change significantly from year to year.  In this area, there were 33 different plans available in 2014.  All of them vary in premium, deductible, formulary, tier levels and prices, and pharmacies that they prefer you use.

Yes, unfortunately, the “donut hole”, (also known as the gap in coverage) will still be in place for 2015.  It will not be until 2020 that you should expect not to pay more than 25% of the retail price for any medicine.  If you have a difficult time paying for your medicines, there is “extra help” available. I can connect you to someone who will see if you are eligible income-wise and will help you complete the necessary paperwork.

As in past years, all Medicare Advantage Plans (also known as Medicare Part C) will change also.  There are insurance companies that are “exiting the market” and a few new ones coming in.  The premiums, co-pays and co-insurance will likely go up. Be sure to check if your doctors are “in Network”. It does not cost anything but a little time, to be certain that you are in the best plan.

If you qualify for Medicare but are still covered under a work health plan, you may very well want to look at your options.  You should be able to get better coverage for a lower cost by utilizing Medicare and dropping your work insurance.  That can be a scary thing to do, but as long as you have a competent advisor, it may well save you money!

I consult for free.  Only if I put you in a new plan, am I paid a commission by the insurance companies. You do not have to pay anything extra to get the benefit of my years of knowledge and experience. Please don’t wait. This election period ends December 7th.

 

 

Confused about Medicare?…. This may help!

Almost every day, I talk with people aging into Medicare. Almost everyone is confused. One reason is that there at least two names for exactly the same Medicare feature.  For example:

A Medicare supplement is the same thing as a Medigap policy

Medicare Part A is inpatient hospital and nursing home insurance

Medicare Part B is medical insurance (doctor, lab, x-ray, ER, etc.)

Medicare Part C is also known as a Medicare Advantage Plan or MA or MAPD (includes a PDP)

Medicare Part D is a prescription plan also known as a PDP

A Gap in prescription coverage is also known as the “Donut Hole”

A low income subsidy (LIS) to help pay for prescriptions is also known as “Extra help”

There are 4 parts to Medicare: Parts A.B,C, and D but confusingly enough when shopping for a Medicare Supplement policy,  you have eleven plans to choose from: Medigap Plans A, B, C, D, F, high deductible F, G, K, L, M, and N.

The Government branch – U.S. Department of Health and Human Services, Centers for Medicare & Medicaid (known as CMS) tries to be helpful.  They have a wonderful publication Medicare & You that is only 140 pages long. It has been my experience that you only get this resource after you have Medicare and even then, very few people will read or understand it.  That is where I come in!  I know and understand this information! However, I do use a flow chart found on page 14, to show my prospective clients.  I find this visual to be very informative. You may find this  Medicare Chart on a separate page on my website.

As always, please feel free to contact me with any questions.  My knowledge is absolutely free to you with no obligation.

 

Original Medicare Benefit Coverage

What is the difference between a Medicare Supplement policy and a Medicare Advantage policy?

They both are meant to enhance Original Medicare (Part A and Part B) benefit coverage. However, they are distinctly different and can not be interchanged.

A Medicare Supplement (also known as a Medigap policy) is purchased for a premium from a private insurance company. The plans are standardized and a good plan (such as Plan F) will basically cover all medical expenses that are not covered by Original Medicare.

Medicare Advantage Plans (also known as Medicare Part C), are plans that are contracted with the Center for Medicare and Medicaid (CMS). You enroll in a specific plan managed by an insurance company. That plans then is responsible for paying for your medical expenses. You are responsible for co-pays and co-insurance.

These plans have to be ,by law, be as good as or better than Original Medicare. They may include extra benefits such as a built in prescription drug plan and discounts on medical related services