Ask The Medicare Specialist
QUESTION:
What are your opinions on what people who read the columns need to know as the Medicare Annual Election Period (AEP) starts this week?
ANSWER:
At The Health Insurance Store, the agents and I are constantly picking each other’s brains and sharing information we discover and client’s experiences so we can better educate ourselves and the public. Today’s question was one I sent to the agents. Below are some of their responses and my added thoughts on each.
From Jennifer Chaney: I think the most common questions and concerns I get are the confusion regarding what different Advantage Plans and companies cover. In addition, lots of people don’t understand how to access or qualify for all the ancillary benefits, especially the newer ones like the debit cards they can use to buy healthy foods or cover medical co-pays, and the latest “Fitness Reimbursement” program.
My thoughts: With so many new benefits available, many don’t know how to use them all or even what’s included in their plan. We’re going to be providing our clients with tutorials next year so they can learn how to utilize and understand everything they’re entitled to. It’s hard to believe how much “free stuff,” as we sometimes call it is included in some plans. The real dollar value can exceed $2,000 or $3,000 annually.
From Tony: For me, it’s the prescription drug maximum out of pocket caps this year and next. Also, people are hesitant on taking or staying with the Stand-Alone Part D drug plan that’s going to have a monthly of less of less than one dollar a month. I hear the same concern about low-cost Advantage Plans. People think they need to choose a higher priced plan because they’re worried the less expensive ones won’t cover something.
My thoughts: Common sense says those fears should be true. But with Medicare, Part D, Advantage Plans, and even Supplements, common sense is often lacking. The bottom line is you don’t have to spend more money to get a better plan and benefits. Usually, the opposite is actually true. The best options for Advantage Plans are less than $50 per month and what we anticipate to be the most popular Stand-Alone Part D drug plan for 2024 will cost less than a dollar. Plan N is one of the lowest priced Supplements and is also the best value for 95% of people who prefer them to HMOs and PPOs. We spend countless hours this time of year analyzing every Supplement client’s medications and what Part D plan is best. This is one of the three essential services we provide: Initially helping them choose the best plan that meets their Indvidual’s health care needs and budget; As plans change annually, ensure they stay on the best possible value in plans and keep them updated on important events in Medicare; And advocate for them when there’s confusion or issues such as erroneous bills, claim denials, or financial strain due to health issues or the need for costly prescription drugs. As far as the caps for medications Tony was referring to, in 2024, once someone on Medicare has spent around $3,200 on medications, all Part D covered drugs from that point on will be $0. This is true for those on both Stand Alone Part D and Advantage Plans. In 2025 that cap will be lowered to $2,000.
From Artrel Foster: I would mention that we’re appointed and/or can help enroll people into every competitive Medicare Supplement, Advantage, and Part D companies. Around this time when agents are trying to flip as many people as possible to generate a commission, it’s important to know we can be their one stop shop and they don’t need to go to multiple companies or agents for information.
My thoughts: I do not mention what Artrel pointed out enough. Being a Medicare “broker” is what allows us to supply our clients with unbiased advice. And we never give it based on how much we get paid or if we get a commission at all. Our only concern is the client’s best interest. If that means telling someone to stay on their current plan or choose one provided through an employer or company they retired from and forgo any commission, so be it. I estimate we give that recommendation to almost 25% of those who seek our help. There are just too many plans to choose from, too many advertisements, too many solicitations in the mail, and ultimately too much confusion. Add in untrained or dishonest agents, and we have a very scary market for seniors. We always protect our clients and shield them from all of that.
From Sadie Humphries: I think many people are having trouble affording their Supplements. People need to know if they don’t decide to move to an Advantage Plan this AEP; they can do it anytime next year because enrollment in 5-Star plans is not limited to any election period.
My thoughts: With the cost of everyday living so high, more and more people need to make, or consider making, the move from Supplements to lower premium Advantage Plans. That needs to be done carefully and only I recommend making that choice after you have sat down with us. Lower premiums and the extra ancillary benefits like dental, vision, OTC, debit cards to pay for food and co-pays, etc., can be extremely helpful. Moving to an HMO or PPO is going to be the right move for many, but not all. It could actually be more costly for some. There’s also a good chance that those on Supplements can reapply for another with the exact same or almost identical benefits for a much lower and affordable cost without giving up what is best about Supplements, nationwide access to doctors and hospitals and no authorizations for medical care.
If you have questions about this column or want to make an appointment for a no- cost consultation during Medicare Annual Election Period that runs October 15 to December 7th, call us or email me. Aaron@ getyourbestplan.com.