Below is some useful information about Medicare. The best approach is to engage with a Medicare expert. Don’t try to do this on your own. There is only money to be lost being a do-it-yourselfer with regards to Medicare decisions. Make you sure you work with an independent agent - not an agent that works for one of the carriers.
The majority of the content in this article was published 9-9-2019 in Advisor Perspectives, authored by Danielle K. Roberts, a Medicare insurance expert and co-founder at Boomer Benefits.
The Medicare AEP (Annual Enrollment Period) runs from October 15 to December 7 each year. If you are age 65 or over, enrolled in Medicare, you can enroll in, change, or disenroll from your current Medicare Part D drug plan or Medicare Advantage plan if you have one.
The election period does not affect Medigap plans.
If you have a standalone Part D drug plan, chances are you have a Medicare Supplement (Medigap plan). The benefits on Medigap plans do not change from year to year, so the AEP has nothing to do with Medigap plans.
This can be confusing. You cannot use the AEP to change from one Medigap plan to another without having to answer health questions. Though a beneficiary can apply for a new Medigap plan at any time of year, this change requires them to answer health questions and go through underwriting in most states.
The underwriter for the new Medigap carrier can accept or decline you based on your answers and the information found in your medical record. Certain prescriptions can also cause an automatic rejection.
Most experts suggest not worrying about your Medigap plan until their next policy anniversary. When that time rolls around, if a rate increase occurs, then that’s a good time to tackle applying elsewhere for a lower rate.
Your annual notice of change letter is important.
Every year in September, your current insurance carrier will mail you an annual notice of change (ANOC). This letter details everything that is changing in the plan next year. The letter will list the plan’s benefits for each year side by side so that members can easily spot any changes that will affect them.
Some of the most important things to look out for are changes in the monthly premium and changes in the drug formulary. A person may like their current plan just fine, but if the plan is dropping coverage next year for an important brand-name medication that is taken regularly, shopping that coverage to find a plan that covers that same medication next year is important.
Medicare has tools to help you evaluate your options.
There are several online resources to help you with your plan decision making. The most important of these is the Medicare Plan Finder tool. You can use this tool to evaluate all your Medicare Part D or Medicare Advantage plan options in your county for next year.you first need to have a ready list of your currently prescribed medications. You can use the tool and enter your list of medications, dosage and frequency. The tool will crunch the numbers and pull up a list of drug plans offered.
The tool is being revised for next year and will no longer retain saved data about prescription drugs. If you wish to save your list of medications, you should first sign up for a MyMedicare.gov account and then enter your drug lists there. This account will also benefit you in managing claims and accessing your personal health information throughout the year.
What to consider when changing Medicare Advantage plans.
You may choose, hopefully with the advice of an expert, to get your coverage through a Medicare Advantage plan. These are private insurance policies that pay instead of Medicare and they have networks of providers. If you wish to change to a different Medicare Advantage plan, you need to verify that your favorite providers are in the network for the next plan. Each plan has an online directory where beneficiaries can search to determine this information.
You may wish to leave your current plan and just return to original Medicare instead of to another Medicare Advantage plan. This can easily be done by notifying the current carrier in writing that you wish to disenroll or calling 1-800-MEDICARE to make the change by phone.
Be aware that if you wish to add a Medigap plan to your original Medicare, health questions may apply. It’s a good idea to apply for the Medigap plan first to ensure they can get approved before disenrolling from their Medicare Advantage plan.
The last application wins.
Because you are bombarded with so much marketing during this time of year, they may make a plan decision and then change their mind later. This is okay. (Of course working with an expert, this probably wouldn’t happen.) You can submit a new application for a different plan anytime up until December 7. The last application processed during the AEP is the plan that will take effect on January 1.
While the AEP can be overwhelming, the process of evaluating plans can be done in an hour or two by working with a good Medicare insurance broker who can do most of the legwork for you.
O’Reilly Wealth Advisors can offer you two aids for this process, no strings attached:
1) We have a great article that speaks to how to prepare for the AEP.
2) We can refer you to the best local health insurance experts specializing in Medicare related health coverage.
Contact us or click on the Schedule Meeting button today!