Annual Election Period

The AEP is fast approaching starting on October 15th and ending December 7th. The AEP is for anyone on Medicare allowing them change to their current health insurance MAPD (Medicare Advantage Prescription Drug plan) or their standalone PDP (Prescription Drug Plan).


The major changes are in the drug plans. The annual deductible is being raised to $400 from $360 in 2016. The maximum allowed in phase 1 is $3,700 for 2017 up from $3,310 in 2016. The donut hole or gap is now $4,950 up from $4,850 in 2016. Lastly the percentage you pay for drugs during the donut home or gap has changed to 51% for generic drugs, down from 58% in 2016 and 40% for brand named drugs, down from 45% in 2016. These changes are moving to 2020 when the donut hole will be closed and you will probably be paying about 25% of your drug costs.


During this timeframe you can change your plans as many times as you want with the last one becoming the plan for 2017.


Please consider using a local broker because it makes sense for several reasons. The first is these brokers go through extensive training to learn about the plans. There is no cost to the Medicare Recipient. The plans pays the broker. If I is go direct there is no difference in the plan premium. Using the local broker costs you nothing but you get the expertise these brokers bring to the table.


Let’s examine what is available.

  1. MAPD plans in Nevada are either an HMO or PPO. There are several choices in each segment. The HMO options in alphabetical order are AARP Medicare Complete, Aetna, Caremore, Humana, and Senior Dimensions. They are all good plans and each offers something different. To learn about those differences please call a local broker to learn about plan specifics. The PPO options in alphabetical order are Aetna or Humana. Each offers two plans. Again call a local broker to learn about plan specifics.
  2. Prescription drug plans (PDP) are also available to change during the AEP. There are 25 different plans available in Nevada, so the difficulty is determining which plan best fits your needs. This is an area that you need to make sure all your current medications are available in the plan you choose. To do that you need to do some homework or call a local broker for help. Here’s what that broker should do for you to help you find the best drug plan for you. He or she will go to and using your home zip code as an identifier load in your specific drugs and let the system show you the plan that works best for you. First you look at the drugs, does the plan cover them all? Next what drug tier are your drugs so you can keep the costs as low as possible. Also can you substitute a generic for a brand drug to lower your costs? Lastly, are there any drug restrictions? Once you’ve examined these factors, you can choose the best plan for you. As I mentioned earlier in this blog, there are 25 different plans available in Nevada. It’s a good chance that your local broker doesn’t represent all those plans (there are plans that do not allow a brokers to sell their plans). In that case a good broker will simply help you enroll in the best plan for regardless if they get paid or not. That’s what I do all the time.


Lastly, if you made a mistake you have between January 1st through February 14th to go back to Original Medicare and get a prescription drug plan or even obtain a Medicare Supplement.


Len Barend, The Barend Agency Inc. 702-250-2200


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