Debunking the Myths & Mysteries of Medicare
by Carl Dye, Independent Insurance Broker
October the 15th is the kickoff for AEP (Annual Election Period) which will run through December 7th. So just what does this mean for those of us already enrolled in one or more of the Medicare programs? What about those who will be turning 65 during this period?
First, this should be the time that everyone assesses their current coverage and decides if it acceptable to their budget and needs. This is best done with the aid of an insurance agent specializing in Medicare and applies to both current and NEW to Medicare members. Without doing some comparison shopping at least every two to three years, one may find their plan too expensive, have changes in deductibles and/or co-payments that are not to their liking or simply to take a closer look at other viable products. Now is the time to meet with your agent for a review of all your policies, but do not wait until the last minute as December 7th can arrive more quickly than you think!
Second, as a rule AEP only applies to Medicare Advantage Plans. These include HMOs, PPOs & PFFS which cover hospital and physician services and usually take minor adjustments to co-payments, deductibles and premiums. However, there may be times when companies decide to take major changes which may include withdrawing from a given territory in order to provide a profitable return to their owners as required by law. Such a major move, however, will generate a termination letter which, in turn, guarantees the recipient a new policy of their choice without having to medically qualify. Should anyone receive such a letter, DO NOT toss it! You will need this when obtaining your next policy.
PDPs (Prescription Drug Plans) may also make changes in pricing and coverages, but the more important area is their Formulary. The changing of tiers for prescriptions or dropping medicines can have a large impact, both positive and negative, on an insured. Everyone should look up their specific prescriptions once you receive your “Notice of Change” this month to verify the upcoming changes for the year ahead. Remember, this is usually the only time frame where one can make a change to any of these plans. It is BEST to be Proactive!
Third, AEP has little impact on Supplements. As previously discussed, Supplements can be written anytime throughout the year IF you qualify medically for one of the insurance carriers that handle these products. However, should you currently be covered by a Medicare Advantage Plan, this may be the time to consider returning to Basic Medicare with a Supplement. Again, you need to qualify medically unless you have a “Guaranteed Issue”. It is also the time to check on your PDP for, as above, you may have to seek out better coverage based on your current prescription needs.
Finally, to assist everyone in the White Mountains Owens Insurance Marketing will be opening a Medicare “Welcoming Center” on the Deuce of Clubs in the Tower Building this month. Our office hours are currently planned from 9 to 5 Monday through Friday. Our objective is to assist everyone in Navajo and Apache Counties obtain the very best Medicare coverage that both meets their needs and pocketbooks.
As an independent insurance agency, we represent several companies that offer a wide variety of products available to seniors. There are several of us available to handle your questions and solve your specific insurance needs. We are your local resource for all of your health insurance needs, as it pertains to Medicare. No appointment required, no commitments asked. Just drop in to say hello!
As in the past, you will also find many of us sitting in Walmart (both Show Low and Taylor),Walgreen’s and the Show Low Safeway the entire AEP. Please stop and ask about the new products, set an appointment or just visit with us. REMEMBER “There is no such thing as a dumb question, just the one that is not asked”! Come by and test us with the questions that you want to ask.
Additionally, we plan on having communication meetings throughout the AEP covering the changes, if any, you may find in your 2017 Medicare Advantage plans. Times and locations to be announced.
For quick answers, I can be reached at: firstname.lastname@example.org or by phone at 928.245.1388. Look forward to hearing from many of you in the coming months and truly believe that, together, we can make YOUR Medicare experience worthwhile!