If ever there was a Medicare Holiday Season, it is the Annual Election Period (AEP). This is when you should be doing an annual review of your current health plan, see what’s changing for the following year and decide whether or not you should change your plan and go through the hassle of changing doctors, if necessary (depends on plan network).
During this time, you should be prepared for an onslaught of mailers, phone calls and emails trying to pique your interest enough to either get you to:
Now, while there is nothing illegal, immoral or unethical about this; if you don’t want to be bothered with unsolicited phone calls, ignore the postcards and phone calls. Especially if you already have an agent you trust. If you do not have your agent’s phone number saved in your phone, with his or her name so you know it’s he or she calling, do so when you’re done reading this article. Any other call, disregard.
Now, with that said, you will receive a letter from your insurance plan carrier (Cigna, Humana, CarePlus, Aetna, UnitedHealthcare, Devoted, etc.) notifying you of changes to your plan for 2022. This is an important document. When you receive it, you should be calling your agent to discuss it and answer any questions you may have.
In preparing for this festive occasion, you should consider these three things:
Let’s look at each point individually.
Today’s Medicare Advantage plans are robust with benefits. This is great because it allows for plenty of flexibility in how you use your plan. However, many times we decide on a plan based on a few benefits that stood out over another plan, but we never really used those benefits. If that’s the case, what may we have given up on a different plan if those benefits were not present in the one we chose? In other words, absent those benefits we didn’t use, would another plan have been better?
Make a list of all the benefits you didn’t use and then ask, “Is this benefit worth keeping?” Now, keep in mind insurance is, well, insurance. In other words, it’s there in the event something happens; but we hope nothing will happen. So, keep that in mind as you ask this question. Be judicious before you decide whether it’s worth discarding or keeping.
Now review your new plan, keeping in mind where the value is most important to you – the benefits you actually use. Are the new changes to your satisfaction? If they are, there’s no need to change your plan. If not, or you’re not sure, then look at what else is available for your area.
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As you start to compare plans, copays, deductibles, coinsurances and any Part-B premium givebacks are easy barometers to decide on. However, look further; look at what you actually used and where your health or needs are now. This will allow you to see if paying a little more in certain copays may be worth it for another benefit that will save you more in the long run.
And don’t forget to look at the network to see if your doctor(s) are in it and the formulary to see if your prescriptions are covered. Not just if they are covered, but are they in the same tier. For example, I have a client who was paying $0 for a particular drug, but when she changed her plan, this medicine became a tier three (3) drug. Due to her being on Extra Help, she only paid $9.20 and not the $35 copay in the plan. However, that $9.20 was something she did not pay previously. She decided that all the other benefits outweighed the $9.20, hence she took the plan and was happy.
These are the things to consider during your annual review. However, don’t just do this annually, but also if your circumstances change. If your income or health change, call your agent and ask how does this affect your benefits? Or, since your circumstances have changed and a Special Election Period may have been triggered, maybe a different plan is in order. Remember, you are not married to your Medicare Advantage plan and there is no underwriting. So, if you need to change to a special needs plan, or from an HMO to a PPO to be able to get the services you require, your agent can help you with that. If someone calls and you accidentally picked up and like what he or she proposed, tell them, “Thank you! I will discuss this with my agent.” And hang up.
As of this writing, October 1st is two days away. Keep your sanity through it all. Avoid all the unnecessary noise of postcards, emails and phone calls, unless they are from a trusted source: your agent or your insurance plan. If you received anything via snail mail or email that intrigues you, call your agent and ask him or her about it. Chances are whatever the mailer is offering, if you actually need it and it’s good for you, your agent can most likely get it for you also.
If you don’t have an agent or your agent is no longer available, feel free to reach out to us at YourCareRep.com. We can help you navigate the tumultuous waters of AEP sanely, safely and simply. To your health!