Now, so what? Most seniors are confused about the AEP and want to know what they can and can’t do during this time period. This time period has nothing to do with a Medicare Supplement.
It’s the time for you to make a decision to either keep your current MAPD (Medicare Advantage Plan or Prescription Drug plan) or make a change. There are so many options in NV; 11 HMO plans; 5 PPO plans and 24 drug plans. How is the average senior going to figure out what they have or should have? They should call an independent insurance broker who specializes in Medicare. That way there are getting an unbiased opinion about the best plan for them.
Facts to consider when choosing a new plan:
- Why am I looking?
- What do I want to accomplish?
- Am I happy with my current plan?
- What don’t I like about my current plan?
- Do I like my Doctor?
- Is the referral process (For the HMO) working for me?
- Does the drug portion of the plan meet my needs?
These are some of the questions you should be asking yourself before you call someone. Once you’ve made the decision to call someone, make sure he/she is answering all your questions. You have to satisfy and keep the new plan for the entire year so you need to get it right the first time.
If you are considering changing drug plans, make sure all your medications are covered by the plan. An experienced broker will go online with you to Medicare.gov and input your medications and then look at the plans available to make sure you’re getting the best plan for the money. Remember, there are typically three (3) different plans to consider: The Saver plans, the preferred plans, and the enhanced plans. Each serves a purpose so choose carefully.
The saver plan typically has a deductible set by CMS. For 2018 it is $405. Most plans require you to pay the deductible first before getting the fixed copays for your drugs. Sometimes you never hit that deductible and will pay the contracted rate the insurance company pays for the drugs. Some plans allow you to buy the preferred generic and generic medications without paying the deductible first. There are many options to look at them carefully. All drugs have different tiers based on the insurance company’s requirements. A generic drug on one plan could be a brand on another plan.
The preferred plans usually don’t have a deductible but have a much higher monthly premium. Then you pay the copays outlined in the plan.
Lastly, there is the enhanced plans with a very high monthly premium but has more drugs in their formulary. This type of plan is for those that take many medicines.
Have your broker so the homework for you to determine the best plan to fit your needs. That’s their job, so make them do it for you.
The Barend Agency Inc.
Len Barend, broker