Extra Help and Changing Your Medicare Advantage Plan: 5 Things to Consider
Medicare is a wonderful benefit. While Medicare is the federal retirement benefit with the most value, there are still many who cannot subsist, due to healthcare costs. The problem is that approximately 50% of Americans over 65 have an annual income of $24,224, and the median pension ranges from $9,262 to $22,172 (according to MedAlertHelp.org). But there is help – Extra Help.
Extra Help, also known as LIS (Low Income Subsidy) is designed to help Medicare beneficiaries lower their prescription drug costs, which can often be the most expensive part of one’s health care. It does so in several ways.
When you qualify for Extra Help, this triggers an SEP (Special Election Period). What this means is you can change your current plan if you wish. Extra Help qualification also allows you to change your plan quarterly, January through September. In the final quarter (from October 15th to December 7th), all Medicare beneficiaries are eligible for AEP (Annual Election Period), so there is no SEP for Extra Help beneficiaries.
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When you qualify for Extra Help and an SEP is made available, many insurance agents are notified and will contact you to see if you wish to change your plan. Now, to be kind, some of those agents may be a bit motivated to get you to change your plan, because it’s how we agents earn a living. Understandable. But it doesn’t mean you SHOULD change.
So, why should you change and why shouldn’t you change? Let’s take a look at those reasons.
In all three cases, give your agent the benefit of the doubt. Call him or her and ask questions, share your concern and get answers. Many times you will find you have a certain plan for one specific reason, based on your unique need. Changing that plan will leave you exposed in one area and is not worth whatever small savings the change would bring.
A good practice to establish is a password for you and your agent. If any other person (other than your actual insurance company’s customer service department) contacts you, if he or she does not know the password, HANG UP! This will avoid confusion and regrets.
Many people aren’t aware they qualify for Extra Help. If you think you may but are not sure, contact us. We can see if you may qualify and help you apply. I always recommend that if you are in the ballpark, apply regardless. You may get denied, but I’ve seen some who I thought would not qualify be approved.
Finally, get with your agent at least once every 4 to 6 months. Find out if there have been any changes that may be advantageous for you. Also, were there any changes in YOUR life that may require doing another needs assessment to ensure your current plan is the right one? This will not only give you peace of mind, your agent will be happy he or she is able to provide you with the best service possible.
Finally, keep in mind we are insurance agents. There are other areas in your life that you may be overlooking, liking final expenses when your day comes that you should at least have the discussion with your agent. Be wise and prudent. Get answers then decide how to best proceed.