It’s time for Medicare Fall Open Enrollment. Knowing how to navigate coverage options and understanding what changes are in store for Medicare in 2020 will help you make the most informed decisions during Fall Open Enrollment.
During this time, you can make changes to your prescription drug plan, enroll in a plan, change your Medicare Advantage Plan, or enroll in a Medicare Advantage Plan.
WHO IS ELIGIBLE FOR MEDICARE? People that are 65 or older or those that have been disabled and collecting social security disability for 24 months.
What to Expect in 2020
Plan F will no longer be offered to newly eligible enrollees. If you have a Plan F currently, your plan will remain the same. If you became eligible for Medicare before January 1, 2020 you will still be able to enroll in Plan F.
Humana had made a change to their prescription drug plan. Those on the Humana Walmart Plan have been re-mapped to the Humana Premier RX plan. Humana is offering a less expensive option, but we MUST make sure your drugs are covered in the new plan. If you want to discuss your options, please have your list of drugs available.
The Part D (prescription drug) deductible has increased to $435. Many carriers offer plan with $0 deductible for drugs in Tier 1 or Tier 2.
Donut Hole: The initial limit has increased to $4,020.
United Healthcare/AARP and Blue Cross Blue Shield have little to no changes to their plans for 2020. If you are happy with your plan, the plan will automatically renew.
Tips to Reducing Your Medicare Premium
Consider a Medicare Advantage Plan. If you are already in one, you may want to consider another carrier. Be sure to pick a plan with a maximum out of pocket and confirm that your doctors accept the plan before switching. This will protect you in the event of a “bad” year.
Consider switching the type of Supplemental Plan you are in currently (i.e. Plan G is often less expensive than a Plan F). I will caution, changing your plan may require you to pay for services that you have not paid for in the past. For example, a Plan N will charge the $185 deductible and $20 co-pay for doctors’ visits.
Review your drug lists with other carriers. Medicare.gov is a great source for reviewing rates with other carriers. Simply plug in your drug information, select your pharmacy, and review the different plans available (based on the drugs you are taking).
Consider switching pharmacies. First, watch to make sure your pharmacy is still in the Preferred Network with your prescription drug plan. Second, find out what the different pharmacies charge for your drugs. You may see a difference that can save you some time in reaching the donut hole.
This is an extremely busy time for me. I suggest scheduling early as my schedule will fill up. Contact me at 708-444-0050 or firstname.lastname@example.org.
Please include your availability (i.e. mornings, afternoons, or evenings) and the type of appointment you are requesting (face to face or conference call).
During this time, individual policy holders can enroll in a health plan or make changes to their existing plan. *If you obtain health insurance from your employer, you are likely to have a different Open Enrollment period.*
What to Expect in 2019
The penalty has been removed! This means you will no longer receive a penalty for not having coverage or for obtaining a plan that does not provide the 8 coverages required by the Affordable Care Act.
Short term medical plans will now offer coverage for the full year. These plans do not provide coverage for pre-existing conditions, maternity, or wellness visits. However, these plans are a fraction of the cost of plans offered through the Marketplace and they all have a PPO network.
BCBS will continue to offer virtual visits for PPO plans only. Policy holders can call or chat online with a nurse practitioner to obtain a diagnosis and prescription for medication.
Group plans are still an option for small employers. Blue Cross Blue Shield does offer relaxed guidelines during this time to allow for a 1-person group. The employer must have at least 2 full time employees that are not husband and wife.
How to Avoid Rate Increases
Be prepared to discuss your household, estimated adjusted gross income for 2019. This will be used to determine if you qualify for assistance.
Those without pre-existing conditions should consider a short term medical plan. The premium is much lower and all plans offer a PPO network. Wellness visits are not included with these plans.
If you are going to opt to self-insure, protect yourself with an accident or critical illness plan. The plan works separate from health insurance and pays you based on a diagnosis of a critical illness (cancer, heart attack, or stroke) and in the event of an accident (slip, fall, and break an ankle) the plan will pay you a certain dollar amount. The purpose is to use the funds to pay towards the unexpected hospital or urgent care visit.
Review ALL of your insurance policies. I specialize in personal lines insurance, which includes auto, home, and Medicare. As a broker, I have access to multiple carriers which allows me the opportunity to find the best plan based on your needs. I’ve saved people thousands by reviewing rates with multiple carriers.
NOTE: This is an extremely busy time for me. I suggest scheduling early as my schedule will fill up. Call 708 444-0050 or email, email@example.com an appointment. Please include your availability (i.e. mornings, afternoons, or evenings) and the type of appointment you are requesting (face to face or conference call).
I will be participating in multiple events during open enrollment.
*Healthcare Reform/”Obamacare” Open House Every Saturday starting October 5th-December 14th 10am-2pm Prime Realty: 17208 Oak Park Avenue Tinley Park, IL 60477 -The open house will be closed November 30th-
*Medicare Open House Every Tuesday October 15th-December 3rd 10am-2pm Additional dates added December 5th and December 7th 10am-2pm Prime Realty: 17208 Oak Park Avenue Tinley Park, IL 60477
*Medicare Community Event for United Healthcare/AARP Plans October 29th and November 13th 10am-11am Prime Realty: 17208 Oak Park Avenue Tinley Park, IL 60477
*Healthcare Reform and Medicare Educational Booth CVS 8811 W 87th Street Hickory Hills, IL 60457 October 16th 2pm-6pm November 6th 2pm-6pm December 4th 2pm-6pm January 15th 2pm-6pm March 5th 2pm-6pm March 19th 2pm-6pm
Feel free to email or call me with any questions or comments about my services or if you have any insurance related inquires.