It’s that time of year again, the Annual Election Period (AEP) is upon us. If you’ve been a Medicare recipient prior to this year, then you are all too familiar with the implications of AEP. If this is your first enrollment season, then you’re about to experience what can be a frustrating and stressful time as a Medicare enrollee.
During the Medicare AEP, beneficiaries are able to alter their coverage under specific programs such as Medicare Advantage and Part D Prescription Drug plans. Often times, people make the mistake of thinking this is also the only time to change Medicare supplement plans, however those can be changed anytime throughout the year. The main things to focus on during AEP are switching from or to a Medicare Advantage plan, and entering into or changing your prescription drug plans.
You may be wondering why it is necessary to monitor these plans during the AEP, and the simple answer is that these plans change in coverage and price every year. If you don’t change or do anything to your existing plans, they will likely be much different in price and/or coverage as you enter into the next year. In many cases, the change can be significant. That’s why it’s always worth having your Medicare advisor analyze your existing plans and medications to ensure you’re still in the most cost-effective plan every year during AEP. Don’t wait, you could end up locked into a plan with a much higher premium or with holes in your coverage if you miss the AEP window (October 15th through December 7th).
In an effort to curb the stress and confusion that comes from Medicare AEP season, we’ve developed a list of 6 things that you should do to prepare.
Analyze your existing coverage thoroughly. Take some time to consider your past year of coverage. Weigh the pros and cons of the specific plan you’re in, the company/carrier of the plan, the total expenses (including prescription meds) of the year. Consider aspects like how quickly your claims were paid, if your doctor had any trouble with your insurance at any point, and if the out of pocket expenses were worth the healthcare you received.
Make note of any changes in medication or health that could impact your plans. After you’ve done a thorough self-analysis of your past coverage, make sure to note any looming changes that could be upcoming in your health. For example, if your doctor suggested a new medication or treatment that wasn’t previously needed when you set up your original plan. Write this all out and give your coverage an overall satisfaction rating for the year. This will help determine what the next move for you should be, and will make you aware of what you need most out of your healthcare coverage.
Compare prices of plan options for the coming year. There are MANY plans, programs, and carriers to choose from. When it comes time to select your coverage for the upcoming year, it’s essential to decide what type of Medicare beneficiary you are. Are you someone who would prefer to pay a little more on a monthly basis in exchange for peace of mind that you won’t have any unexpected expenses? Or would you rather pay a lower monthly premium and take the risk that your coverage may require high out-of-pocket expenses should you have a health issue? If you can answer this question for yourself, you’ll give a better starting point to determine what plan/program is a better fit and how much you will spend on said plan.
Make a list of your current medications, dosages, and frequency. After analyzing the entirety of your coverage, the next step would be to write down every medication you take, the dosage, frequency, and brand. This list is going to guide your Part D plan selection.
After completing steps 1-5, set an appointment with a Medicare advisor. After you’ve done the previous five steps, you have painted yourself a pretty thorough picture of your healthcare needs. Now it’s time to take this information to your Medicare advisor, so they can analyze and help you select the best coverage at the best price. Completing steps 1-5 prior to your call or appointment will make the process go much faster and smoother for you. *Helpful Tip: Always work with a non-captive Medicare advisor. They have access to all the plans and companies, not just one of them. This ensures you are in the best plan at the best price.
Remember, in order to ease the confusion, contact a Medicare representative to help make this AEP much smoother. If you don’t have a dedicated agent or aren’t sure, our toll-free Medicare hotline is open for questions, comments, concerns for anyone in the United States who needs consult on their Medicare plans/coverage at (888)-404-5049.
We’ve said it before, and we’ll say it again, Medicare is confusing. Which is why we dedicate our lives to helping seniors PREPARE for Medicare before they enroll. Knowledge is power! So with that being said, here is a list of 10 things that you probably don’t know about Medicare, and some of them may surprise you!
Medicare covers more than just senior citizens. Medicare is designed for the aging population, but under certain circumstances, people under the age of 65 can be enrolled. If you have a qualifying disability or End Stage Renal Disease (ESRD), you can get covered under Medicare.
Baby boomers are aging into Medicare at a rate of 10,000 per day. Back when Medicare was first designed, people weren’t living nearly as long as they are today. Add that to the baby boomer generation who are rapidly aging into Medicare at a rate of 10,000 people PER DAY, and you can see how Medicare is quickly going to get into trouble.
Enrollment can happen outside of AEP. There is a common misconception surrounding Medicare that you can’t change your plans unless it’s during the Annual Election Period (AEP) from October 15-December 7. While this is true for Medicare Advantage (Part C) and Prescription Drug Plans (Part D), you can change from Medicare supplement plan to plan anytime you want. There are always “special election periods” and change of status that can warrant a change outside of AEP as well.
Each part of Medicare covers something different. While the parts of Medicare can be the most confusing part, it’s all for good reason. Each part of Medicare means something different and works differently. Part A is for your hospital care, Part B is for healthcare outside of the hospital such as routine doctors’ visits and preventive care, Part C is Medicare Advantage, and entirely different program from original Medicare altogether, and Part D is the prescription drug plan. Every part works differently to make one whole picture.
How much Medicare actually pays out. Medicare supplemental insurance was created to fill in the coverage gaps left behind by original Medicare. Did you know that traditional Medicare only covers 80% of the Medicare-APPROVED costs? That means, YOU as the enrollee are responsible for that other 20%. This is where Medicare supplement insurance comes in. It covers your 20% if you keep up with your monthly premiums, and can save you a ton.
A “non-participating” doctor still takes Medicare. Despite what the status title of “non-participating” doctors suggests, doctors under this status DO accept Medicare. They just don’t accept it at the amount that Medicare pays, meaning these doctors reserve the right to charge the patient additional money on top of what Medicare approves. While it seems confusing, don’t be too alarmed if your doctor becomes a “non-participator”- it just means that they reserve the right to charge you 15% more than Medicare approves. This is typically only found with specialty doctors/treatments.
Waiting to enroll in Part D can cost you FOR LIFE. Once you’ve reached Medicare enrollment time, you also have to enroll in your Part D drug plan. If you don’t, you have to wait until the following AEP, AND Medicare charges a fee every month for the rest of the time you’re on Medicare (aka, the rest of your LIFE!) While the fee is minor, it can add up depending on your lifespan. 1% of the national average in premiums in what you pay PER month, so 12% per year, lasting forever.
Medicare doesn’t cover everything. If you’ve been to your doctor for a physical and you WEREN’T charged for it, your doctor didn’t file it properly. Physicals and some other procedures aren’t covered under Medicare. While Medicare paired with a supplement covers almost everything, and mostly the big stuff, it doesn’t cover everything.
Medicare doesn’t work outside the USA. Getting ready for a big vacation to Europe? Make sure you understand before you go that your traditional Medicare coverage doesn’t apply out of the country. If you have a Medicare supplement, you’re covered. However, traditional Medicare without a supplement or Medicare Advantage does NOT work outside the United States.
On average, with Medicare you get WAY more than you pay for. While your Medicare premiums and co-pays do add up, compared to the average amount of usage, you are saving a TON. Medicare may not be perfect, but it is still possibly the greatest government healthcare coverage known to us. Take advantage of it by preparing yourself properly with a supplement so you don’t get stuck with huge bills, but rather a predictable monthly premium.
It’s true; Medicare is complex. But it’s one of the best working healthcare systems out there, and if used properly it can save enrollees a ton of money in their health care and keep them healthier, longer.