Important things to know about Annual Enrollment

Annual Enrollment Period, (AEP) also know as Open Enrollment Period (OEP) is from October 15th through December 7th each year.

All Medicare Advantage Plans and all Prescription Drug plans will change annually.  Medicare supplements (Medigap) benefits will stay the same and automatically renew.

  • It is important to “shop” for a plan every year..  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 the upcoming calendar year.
  • If you are satisfied with your existing coverage, it will automatically renew for the next year.
  • If you want to change plans, this OEP is the time to make the change.
  • Be an educated consumer.  Changing plans could save you thousands of dollars per year.

Medicare Costs to Beneficiaries for 2018

Every year the Centers for Medicare and Medicaid (CMS) may change the out of pocket costs to Medicare recipients (known as beneficiaries).  In 2018, the Part A premium will continue to be $0 for most beneficiaries.  The Part B Premium will be $134 per month depending on your household income.  Those with higher incomes will pay more.  This is called IRMAA  and it based on a sliding scale. Feel free to contact me for more detailed information.

The Part A Hospital Deductible is $1340 per benefit period.

The Part B Medical Deductible remains stable at $183 per calendar year.

A Rehab/Nursing home stay will cost an additional $167.50 per day for days 21-100.

Please know that a supplemental Medicare policy (Medigap) may help pay for these increased costs.  Those who have Medicare Advantage Plans need to read their Summary of Benefits document since each plan has different premiums, deductibles and copays.

Don’t Miss Medicare Annual Enrollment Period

Beginning October 1, 2018 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 24 different plans available in 2017.  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 2018.  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.

 

 

Unhappy with your Medicare Advantage Plan?

For those who enrolled or were re-enrolled in a Medicare Advantage plan for 2014 and are having “issues”, there is a way out;  But you need to act before February 14, 2014. Maybe your doctors are not in network, or a prescription you need is not covered. The government wants you to stay in your plan the whole year but will let you out in this special time called the Medicare Advantage Disenrollment Period (MADP).

It is important to know that this will return you to original Medicare.  You do have a guaranteed right to get into another prescription plan.  In addition, you may be able purchase a Medicare Supplement or other Medigap policy if you qualify. You may not enroll in another Medicare Advantage plan for this year.

If you are confused or want clarification, please feel free to contact PQ Wallace Insurance for a no obligation consultation. 757-232-4678 or pqwallace@pqwic.com.

 

 

 

 

 

 

 

 

 

 

 

Newport News Shipyard Retirees Losing Medicare Coverage

I am concerned about the amount of “unease” and lack of choices being expressed by retirees of Newport News Shipbuilding about the loss of their supplemental Medicare coverage.   There been several articles in the Daily Press about the letters that Huntington Ingalls Industries sent to their former retirees informing them that they need to use ExtendHealth to counsel them about their Medicare options.

I wish to share some important information that should have been explained to those affected.  I can offer this information because I have a reputation as a Medicare insurance “subject matter expert.” I am a licensed independent insurance agent who has specialized in helping Medicare eligible beneficiaries over the past 9 years, understand all the options available in the local market.

Because these Medicare eligible retirees are losing their supplemental insurance through no fault of their own, Medicare requires that insurance companies that offer Medicare Supplements, Medicare Advantage Plans and Prescription Drug Plans, offer plans that are guaranteed issue.  In other words, the retiree can purchase, an excellent plan, regardless of existing medical conditions, at a more competitive premium. Many of the plans use Medicare as the primary insurance and as long as a doctor or healthcare provider “accepts” Medicare, the Medigap plan will pay most, if not all the remaining charges. There is no need to worry about networks and the medical coverage will be as good as what they now have.

The prescription drug coverage, however, may or may not be as good. All reputable agents “shop” for the best prescription plan to meet each individual’s needs.  However, all of the available plans are subject to a gap in coverage, also known as the “donut hole.” The Centers for Medicare and Medicaid (CMS) will not allow any marketing of the approved 2014 plans until October 1, 2013.  This explains ExtendHealth’s reluctance to discuss specifics until then.

What remains unclear to me is whether the retirees must go through ExtendHealth in order to receive any funds from their retiree reimbursement accounts. If this is the case, then obviously HII is limiting the retirees’ choice of using a local, knowledgeable, reassuring and face to face agent.

Changes – Good & Bad for PDP’s in 2014

I have been spending enormous amounts of time certifying so that I can enroll you the Medicare plans you may want in 2014.  I always tell my Medicare clients that they “need” to shop for Prescription Drug Plans each year, in order to save money and hassle.  Really, if you do not want to do this, please let me help!  If you do nothing, you will receive an ANOC letter (annual notification of change letter) from your current plan.  If you are okay with the changes (usually a jump in premium amount), you do not need to do anything and your plan will automatically re-enroll you for 2014.  Experience has taught me that you could possibly save hundreds – even thousands of $$$$ just by making a phone call to me.

The new 2014 plans will be available to shop on Oct. 1, 2013 though I can not accept an application until Oct. 15, 2013.  This enrollment period will end Dec. 7th, 2013.  The good news is that some of the dollar limits have actually gone down!  For example, the maximum deductible will be $310 instead of the $325 that was in place for 2013.  The bad news is that the amount to reach the donut hole is lower for 2014: $2,850 versus $2,930 in 2013.  The good news is that you will pay less while in the donut hole and get out of it a bit sooner.  The maximum yearly “out of pocket” drug costs will be $4,550 for this coming year as opposed to $4,750 this year.  While in the donut hole, you will get a 28 percent discount on your generic drugs versus the 21% discount in 2013.  This is SLOW but sure progress for the total elimination of the donut hole by 2020.

I am getting excited about helping my existing clients and always welcome new clients!  Please remember to refer your friends, neighbors, and family to me. I appreciate your business!

Medicare Prescription Plan

What is a Medicare Prescription Plan and how do I get one?

Medicare Prescription Drug Plans (also known as Medicare Part D and PDPs) are generally highly recommended if you have Medicare and no other creditable prescription drug coverage. To get Medicare Drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered. Sometimes a PDP is included in your Medicare Advantage Plan at no additional cost. These plans are called “MA-PDs”.