With the Annual Election Period (AEP) coming up from October 15-December 7, it is a critical time to review your Medicare Plan.  Because of the limited time frame, you’ll be receiving A LOT of advertisements—by mail, email, social media, radio, newspapers, phone calls, and television.  It WILL be overwhelming!

Medicare Prescription Drug Plans cover medications.  Some people have their Prescription Drug Plan built in to their Medicare Advantage Plan, and some people have a stand alone Prescription Drug Plan.  Regardless of how you receive your prescriptions, it makes sense to review every year!

Most states have a large number of Prescription Drug Plans to choose from.  For example, in Illinois alone, there are 27 different plans to choose from.  How do you narrow it down?

Some things to consider:

What are your medications?

• Each plan has a formulary, or drug list.  These formularies are not the same from plan to plan.  Checking YOUR medications against each plan’s drug list is important. You don’t want a big surprise that your medication isn’t covered for 2019. 

What pharmacy do you use?

• Each plan has a network of pharmacies.  Some plans have broader networks, and some are very specific to a certain pharmacy.  Most, but not all, have mail order vendors that can reduce the cost. 

What is the plan premium?

• The plan premium is important, but the overall cost (premiums, deductibles, and co-pays) is the most important factor.

What is the deductible?

• Medicare’s standard deductible is $415 for 2019.  Some plans include this full deductible, some have a lower deductible, and others have $0 deductible.  Some of the plans have a deductible on only certain levels of medications.

What are the medication co-pays?

• Each plan has a variety of medications tiers, or levels.  Typically plans have 5 tiers of medications.  Check which tiers your medications are on to see what your co-pays will be.

As you can see, there is a lot to consider when analyzing a drug plan.  One handy tool is the medicare.gov plan finder, where you can input your medications and your pharmacies. Also, your area’s Senior Center likely has SHIP counselors who can do these reviews for you. 

We do Prescription Drug Plans reviews and analysis in my office as well, so if you’d like assistance, please give us a call.  

Medicare Advantage and Medicare Prescription Drug Plans have limited enrollment periods in which members and prospects can make changes.  It can be difficult to keep track of these periods of time, but as a Medicare beneficiary, it is critical that you know WHEN you can make changes to your plan.
 
Annual Election Period (AEP)—October 15-December 7

• You may make AS MANY changes as you wish to your Medicare Advantage and/or Prescription Drug Plan.  All enrollments using the AEP will be effective January 1. 
• You may switch from one prescription drug plan to a different prescription drug plan.  You may switch from one Medicare Advantage plan to a different Medicare Advantage plan.  You may switch FROM a Prescription Drug Plan to a Medicare Advantage Plan (and vice versa). 
• This is a very useful time, because it’s your opportunity to shop around and make sure your plan fits your needs the best.
• If you make a selection and submit an enrollment in October, but change your mind and want a different plan, you can submit a new enrollment prior to December 7. It doesn’t matter how many enrollments you submit; the one that goes in LAST is the one that will be in place on January 1. 

Open Enrollment Period (MA-OEP)—January 1-March 31 NEW IN 2019

• In certain circumstances, you may make ONE plan change during OEP. All enrollments using the OEP will be effective the first of the following month. 
• If you have a Medicare Advantage Plan, you may switch to a different Medicare Advantage Plan OR a Prescription Drug Plan with Original Medicare.
• This might be useful if you find your current Medicare Advantage Plan isn’t meeting your needs.  You can use this period to make one change, so use it carefully!

Special Election Period (SEP)—varies

• These periods vary based on your circumstances.  The most frequently used SEPs include moving out of your plan’s service area, losing group coverage, and having, gaining, or losing the Low Income Subsidy. 
• Each SEP allows for a certain amount of time to make changes.  Call your agent for details based on your situation!

Initial Enrollment Period—based on your Medicare effective date

• This coverage is based on your Part B effective date.  For most people, this when they turn 65, but it could be different if you gain Medicare eligibility due to a disability or if you delay your Medicare due to having an active employer plan.
• This is a 7 month window that begins 3 months prior to your effective date, the month of your effective date, and 3 months following your effective date.  Most plans using the IEP begin on the first of the month in which you gain Medicare eligibility.  However, if you wait until the end of your IEP, your plan will be effective the first of the following month. 

There’s a lot to keep track of with Medicare election periods! Feel free to reach out if you have questions or if you need to make changes.  

Medicare's Annual Election Period (AEP) is coming up between October 15-December 7, and it is a critical time to review your Medicare Plan.  Because of the limited time frame, you’ll be receiving A LOT of advertisements—by mail, email, social media, radio, newspapers, phone calls, and television.  It WILL be overwhelming!

Medicare Advantage Plans are a popular plan choice for many Medicare recipients.  Currently, about 35% of Medicare beneficiaries are on a Medicare Advantage Plan, with projected enrollments to rise to about 50% by the year 2024.

Is a Medicare Advantage Plan right for you? Obviously, many people think so.  There are more and more plan offerings every year, so it would be wise to at least review the options available to you. 

(This is NOT a blanket recommendation to take a Medicare Advantage Plan.  Please discuss your situation with an agent to determine if this is a suitable plan for you).

Some Medicare beneficiaries have over 20 Medicare Advantage Plans available where they live.  They are not all created equal! When comparing Medicare Advantage Plans, there are some key points to consider.  For every plan you look at, make sure to ask these questions:

Network—Most Medicare Advantage Plans have a network.  Is this plan an HMO or a PPO? Are your doctors in network for the plan, or would you need to change doctors? What would happen if you went out of network with this plan?

Referrals—Are specialist referrals required by this plan?

Premium—What is the plan’s monthly premium? Does it fit into my budget?

Co-pays/Co-insurance—What out of pocket expenses would/could you incur?

Maximum Out Of Pocket—All Medicare Advantage Plans have a Maximum Out of Pocket amounts. Compare this to see what your “worst case scenario” could be.

Prescription Drug Coverage—Is Part D included with this plan? If not, can you add Part D to the plan? What are the prescription co-pays? Are all your drugs covered on the plan, or would you need to change your medications? Is your pharmacy in the preferred network, or would you need to change pharmacies?

Extra Benefits—Many Medicare Advantage Plans have extra benefits, like gym memberships, dental, vision, hearing aids, meal programs, weight loss programs, Over the Counter supplies, and more.  Compare the options between different plans to see which would benefit you the most.

Agent/Broker—will you have a dedicated agent you can reach out to? If you have questions, is the agent available to help you?

These are some of  the key points to consider when choosing between Medicare Advantage Plans.  There’s a lot to digest! Independent brokers will be able to help you analyze and choose plans based on your situation, so you won’t have to do the heavy research if you don’t want to. 

As always, I certify with all the top carriers, and I do the heavy lifting for my clients and prospects.  Please feel free to call me at 815-232-7726 or email me at [email protected] with any questions, or to schedule a time to discuss your Medicare Advantage options!

Medicare’s Annual Election Period is quickly approaching.  There are several things you can do today to make sure you’re prepared for this critical time period.

During the Annual Election Period, also known as AEP and Open Enrollment, you can make changes to your Medicare Advantage and/or Prescription Drug Plan. It is wise to review your plans each year, as plans can change significantly from year to year. 

Since AEP is such a short window of time, there are some key steps for you to take RIGHT NOW to make sure you don’t miss your opportunity to review.

• Update your Prescription Drug List—maybe you carry an Rx list in your wallet.  If so, double check it to make sure it’s up to date.  Remove any medications you are no longer taking and add in any new ones.  If you don’t have a current copy, gather up your prescription bottles and make a list OR contact your doctor a pharmacist to get an up to date printout.  This is an important step because any new plan analysis should factor in your current medications.

• Find your Medicare card—If you decide to make any changes, you’ll need your Medicare card.  New cards were recently sent by Medicare, so make sure you know where it is! If you can’t find it, be sure to request a new one.

• Make a list of all your doctors and pharmacies—Some plans have doctor networks (some don’t!).  Having an up to date doctor list is helpful in analyzing plans.   

• Analyze your 2017 and 2018 health care spending—Think about how much you spent on health care in the last 2 years.  List your monthly premiums (if any), your doctor and specialist co-pays (if any), your hospital co-pays (if any), etc.  If you don’t know the numbers off hand, find them! You can look for Explanation of Benefit forms (sent by Medicare or your Medicare Advantage plan) and look at your total out of pocket costs for the year.  Knowing this information is critical to making an informed decision about your coverage.

• Make your Annual Election Period appointments—agents have a lot of people to see in 8 weeks. Make sure you don’t get missed.  Call 815-232-7726 and get on the schedule now so you’re sure to have your review before the opportunity runs out.

Every year, AEP becomes more and more important.  The steps you take TODAY will set you on the right path to making sure you’re on an appropriate plan.