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Prepare for Medicare AEP

It may not feel like it now, but summer is almost over. Before you know it, Fall will be here.  And, with it the Annual Enrollment Period (AEP) for Medicare and Medicare Advantage insurance plans. Now is the time to prepare for Medicare AEP.

The AEP runs from October 15th through December 7th. This is the time when beneficiaries can choose to re-enroll in their existing plan, switch from Original Medicare to Medicare Advantage, add a Medicare Part D or prescription drug coverage plan.  Or opt to stay with Original Medicare and purchase a Medigap policy. Comparing plans can save beneficiaries significant money in premiums as well as make sure that their basic needs for their changing health status are covered. According to a survey conducted by Deft Research, over 44% of seniors shopped around during the Annual Enrollment Period of 2020. Whatever the changes will be, here are five ways you can start getting ready to make informed choices for your healthcare and medical insurance needs:

Read your ANOC

An ANOC is a Plan Annual Notice of Change, and insurance carriers are required to send them out to their beneficiaries each year. Its purpose is to inform members of a plan as to what changes will be coming to that plan in the following year. Some possible changes might be raising the premium, your healthcare team no longer being in-network, or adding or discontinuing extras like dental or vision. There have even been cases when an insurance plan was completely gotten rid of, and those beneficiaries had to choose a new one regardless of whether they had planned to switch. The ANOC will have all the information you need to know about what will be different next year.  Begin preparing for Medicare AEP by understanding what you currently have.

Stay aware of the timeline

The timeline for Annual Enrollment goes like this: on October 1st, new plans are released.  This gives people time to peruse and compare before the enrollment starts on October 15th. December 7th is the deadline for making a choice in coverage. The more research you do, the more informed you’ll be.

Work with a broker to Prepare for Medicare AEP

Brokers work with multiple insurance companies.  They are uniquely suited to help you compare and contrast the ins and outs of  plans. Doing this process with a broker may help you save significant time on research.  They are in the business of knowing all the details you would be looking for.  A reputable broker is a must to prepare for Medicare AEP.

Make a list of your important questions

You have to know what you need and want in a healthcare plan before making a choice – otherwise you may end up with a plan that doesn’t suit your needs at all. Some questions to ask might be: Is my doctor in-network? Is this prescription that I need to take covered? Will there be vision and dental coverage or is that extra?  Make note of this when preparing for Medicare AEP.

Review the logistics of enrollment

There are several options for enrolling in a new plan: you can meet with an insurance representative face to face, fill in and mail all the paperwork yourself, or enroll directly with a broker who will walk you through the process. And, although it’s normal to be hesitant to make any big changes in healthcare coverage, remember that, whichever plan you choose, it’s only for the next twelve months. Annual Enrollment Period will be back next year.

Licensed Agents – Prepare for Medicare AEP

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Medicare Annual Enrollment 2023

As we get closer to the end of the year, many people start thinking about the Medicare Annual Enrollment 2023.  During this time of the year, you can make changes to your Medicare coverage for the upcoming year.   It is important to note; each year Medicare plans change.  Some plans add benefits to a plan or change the way they cover a medication.  Whether you’re a first-time Medicare beneficiary or have been on Medicare for years, you should check your plan each year to stay informed about the changes that may effect your coverage for the following year.

When is Annual Enrollment 2023:

Medicare Annual Enrollment begins October 15, 2022 and ends on December 7, 2022.  During this time, you’ll be able to make changes to your Medicare coverage for the upcoming year.

What changes can I make during  the Medicare AEP

1. Beneficiaries of  Original Medicare may change to a Medicare Advantage plan.
2. If you are on a Medicare Advantage plan you can change to Original Medicare.
3. You may decide to enroll in a PDP (Part D, prescription drug plan).
4. You can also change from one Medicare Advantage plan to another.
5. Some people switch from one PDP plan to another.
6. Other individuals may choose to drop their Part D coverage altogether.

Things to consider before changing your Medicare coverage:

1. Each year you should review your healthcare coverage. Many people find it invaluable to enlist the expertise of a licensed insurance agent for this.  Because there are so many plan options it can get confusing.  Make sure you understand your current coverage so it will be easier to compare it with the best plan choices for next year.
2. Think about your health care needs especially if they have changed.   If possible, try to consider what you may need in the upcoming year.
3. If you are on a Medicare advantage plan, be sure to check that your health care providers will still be in-network.  Providers and facilities (hospitals, labs, out patient clinics) do make changes during the year and if you skip this step, it could be very costly.
4. Members of PDP plans need to carefully check their plan’s formulary.  Private insurance companies do change these each year and something that is covered this year may not be next year.  It is possible there is a prescription drug plan that is a better fit for you for next year.
5. If possible, it is a good idea to look at the total cost of this year’s plan (plan premium, deductibles, co-pays and co-insurance) to see if you can save money next year. It is important to think about your budget as well as your healthcare needs.

There are many resources to help you learn more about the Medicare Annual Enrollment 2023:

1. Visit the Medicare.gov website: The official Medicare website provides information about all aspects of  Medicare.
2. State Health Insurance Assistance Programs (SHIPs): SHIPs offer free, personalized Medicare counseling and assistance.  These programs can also provide valuable information on programs for those with a limited income.
3. Medicare and You Handbook: The Medicare and You Handbook is a comprehensive guide to Medicare that is updated each year and mailed to all Medicare beneficiaries.
4. Call a local insurance agent.  Make sure the agent is licensed and appointed to sell the most competitive plans in your area.  If you find a reliable and knowledgeable agent, this will help narrow down the choices for you to make an informed decision.

The Medicare Annual Enrollment 2023 is an important time of year for Medicare beneficiaries to review and make changes to their coverage. By staying informed and considering your health care needs, you can make the best decisions for your health and budget.

Please note;  any changes you make during the Medicare Annual Enrollment period will not take effect until January 1, 2024.

There are other enrollment periods that yo may be able to take advantage of during the year.

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Choosing Medicare Supplement or Medicare Advantage

Choosing Medicare Supplement or Medicare Advantage plans can be both confusing and frustrating. Many seniors simply go with a company name they are familiar with (Most commonly AARP). A plan that a relative or friend suggested or they just stay in their current plan because that is what they have always had. The end result is usually a bad choice of plan for the given situation. The reality is that there is not one “best plan” for everyone. To choose the best plan for the situation, it is important to know all the options available.

Here is a quick overview of the options available to Connecticut residents and the strengths and weaknesses of each…..

Medicare Supplement Plans:

Medicare Supplement plans are secondary plans you can purchase from a private insurance company to help cover the gaps in Medicare part A and B.  In all states, the plans offer standard benefits.  Plans provide different levels of coverage.  This depends on which plan you choose. The plan benefits cannot change.  This means any company that offers a plan must offer the exact same benefits. For Example Plan N with Anthem BCBS is exactly the same as Plan N with AARP (United HealthCare). The only difference is the rate that the private company charges for them. Please keep in mind, the rate can vary greatly.  One company in CT charges $184.00 a month for plan J while another charges over $300.00 for the exact same plan.

Supplement plans are best for a person who uses a high volume of health care services. Supplement plans tend to be costly but have very little out of pocket expense. If someone is consistently receiving a high volume of medical services, it may be wise to look at a supplement.  It may also be wise to use a supplement as some doctors that will not accept Medicare Advantage plans. In such a case, a Medicare supplement plan will provide coverage when an Advantage plan will not.

If you are in the market for a supplement plan it goes without saying that AARP should be considered.

They currently have the best rates available.  If you are considering plan F, you should purchase plan J instead. Plan J cost less, has all the benefits of F and some additional benefits as well.

The drawback to a supplement in the monthly premium cost compared to the premiums of Medicare Advantage plans. Also, supplements do not come with Rx coverage which must be purchased separately if it is needed.  If you are not a high volume user of medical services, it is warranted to look at the available Medicare Advantage plans.

One last thing to mention with supplements is that some people are simply more comfortable with them.  For some seniors the most important thing is to be able to see any doctor and not worry about copays or anything associated with managed care.  The person who feels this way may be willing to pay the extra monthly premium for this luxury.

Medicare Advantage Plans:

Medicare Advantage Plans are a low cost way to for seniors to obtain health care coverage. Advantage plans provide benefits equivalent to Medicare Part A and B with most plans providing additional benefits beyond what is covered by A and B. The plans can come with or without Rx coverage build into the plan design. Medicare advantage plan administer your benefits instead of Medicare Part A and Part B which makes the plan primary. Premiums range from $0 monthly premium to $179.00 month premium depending on the plan selected.

Medicare Advantage Plans do have some drawbacks compared to supplements such as the fact that you need to stay in network in most cases (There are PPO plans with out of network benefits)  There are also copays associates with services.  The higher premium plans have very low or no copays for many services but the lower premium plans ($0 premium) tend to have more out of pocket costs on things such as hospitalization)

Here is a breakdown of the plans available in Connecticut for 2009….

AARP Medicare Complete:

Positives– $0 monthly copay, Rx coverage build in with Medical, very low copays to primary doctors and specialists and out of network coverage.
Negatives– The network can have a lack of physicians in network in certain parts of the state, New Milford and some other key hospitals are not participating and the hospital copay is stiff at $225 a day for a total of 17 days.

Aetna Golden Medicare:

Positives-The Golden Medicare plans offer a national network which is nice for people who travel out of the Connecticut area. The Physician and hospital network is now one of the largest in Connecticut.  The $59 plan is the lowest cost plan on the market that still covers Inpatient hospitalization at 100%. There are a number of different plans to choose from including PPO options that provide out of network coverage, the $0 premium plan offers strong benefits compared to the rest of the $0 premium plans in the market.
Negatives-Some drugs fall into the 4th tier when they are only 2nd tier with other plans.

HealthNet:

Positives- Strong provider network, many high dollar drugs are on the 2nd tier.
Negatives-At current premium levels, the benefits are not competitive with other carriers in the Connecticut market. The Navy plan has weak benefits ($150 copay for 5 days inpatient hospital) for the high premium charged ($179.00)

Evercare (Secure Horizons/United Health):

Positives-$0 premium plans with low physician copays and Rx coverage, Chronic conditions plans coverage more conditions than any other in the state, only Dual Eligible Plan (Medicare and Medicaid) offered in CT market.
Negatives- High out of pocket costs for inpatient hospitalization, weak network can be difficult to deal with from an administrative standpoint, weak out of network benefits compared to AARP Medicare Complete

Be cautious of anyone who is only able to sell one or two of the companies listed above.  If they only offer a few plans, they may not know everything available that could best fit your needs.  Find someone who has the ability to work with all plans available in Connecticut in order to see all of the choices.  Although there are a number of plans available, each person has their own needs.

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