Big Changes for 2020 Medicare Open Enrollment

Medicare Annual Election period is Oct. 15-Dec.7 each year. This year’s open enrollment threatens to make the initial rollout of the Affordable Care Act (ACA) plans look like a picnic.

The Medicare Plan Finder has been “upgraded”. Historically, this website has been an elegant tool with few errors.

We were notified of the “upgrade” in August and volunteered to help test it, to no avail. As of this writing it is a mess! We are finding inadequate functionality such as inability to do detailed comparisons, print or save reports, and errors that do not match with the insurance company websites. ” Most agents and our professional associations are begging to reopen the old platform.

Go to https://www.medicare.gov/plan-compare/#/?lang=en, to see if you can get the information you need. If not, you may also call your carrier or HICAP at 223-0999 to set up an appointment.

As usual most of the Part D Rx plans are changing benefits, premium and formulary. You should be receiving your ANOC (Annual Notice of Change) regarding your current plan. Review it thoroughly to determine if you are interested in shopping your plan. There is always a “cost” to change, in learning new procedures, setting up new mail order etc. Check the new premium and your costs for your medications on the plan. If your drug is no longer on the formulary, is there an alternative that is covered? Check with your doctor about whether this medication would be appropriate for you.

With the chaos this year, if you can stay on your current Part D Rx plan, you will probably be glad you did.

The Part D Plans for Humana are being changed dramatically.  The 2019 Humana Walmart Plan and the Humana Enhanced Plan will be automatically rolled into the 2020 Humana Premier Rx plan.  This means a premium increase to $64.50 in California.   However, two New Part D plans will be available: Basic RX plan ($33 mo.) and the NEW Walmart Value RX Plan ($13.20 premium). If you wish to move to one of the lower cost plans, you may contact Humana directly at 1-844-258-0533 to request the change.

Medicare Advantage (MA and MAPD) coming to Shasta County 1/1/2020:

There will be two new Medicare Advantage (Part C) plans available for 2020. They are offered by Anthem Blue Cross and United Healthcare (AARP). Some folks may recall that United Healthcare had to close their Shasta County plans several years ago, leaving many insureds scrambling for new plans.

The UnitedHealthcare plan is an HMO, which means you must use their providers or you receive NO benefits. Note: UCSF and UCDavis are not in the network. Monthly premium is $61. You may review the network at: www.UHCMedicaresolutions.com. Scroll down and Click on Find A Provider, enter you zip code and choose Secure Horizons (HMO).

The Anthem product is a PPO which allows you to go out of network and receive lesser benefits. Monthly premium is $26. This is different from a Medicare supplement that pays without regard to a network. With Medicare and a standard supplement, all you need to know is if your provider takes Medicare at some level. With the Anthem plan it will be important to know if the providers are part of the PPO network.

You may look up providers at: https://www.anthem.com/medicare/medicare-advantage-plans/. Enter you zip code and 2020 plan year. Choose the Anthem MediBlue Access (PPO) for those not also covered by MediCAL.

The MAPD (PART C) plans include the Part D Rx benefit in the package. But you will want to review the formularies carefully. Each of the websites allows you to check your drugs’ coverage under the plans. These plans include additional benefits such as hearing aids, vision or dental benefits. There are copays and deductibles and the maximum out of pocket in the event of a very serious illness is $6700.

A Medicare supplement F or G would leave you with little or nothing out of your pocket for covered Medicare services and give you more freedom of choice of providers. Prescription drug out of pocket costs will depend on the Rx you use and your choice of Part D plans. Medicare has an excellent publication available to help you understand the differences: https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf.

One important fact to remember. If the MAPD (Part C) plan does not work for you, you will have only ONE opportunity to return to Original Medicare and be guaranteed issue for a supplement.

Don’t forget to set up your user name and password at the www.mymedicare.gov. There are many resources available on this site, including the new “blue button” where you can allow selected individuals access to your Medicare information to better assist you manage your benefits.

Margaret R. Beck

Margaret Beck CLU, ChFC, CEBS started her insurance practice in Redding in 1978. She is the founder of Affiliated Benefit Services where businesses and individuals are assisted in choosing proper products, compliance with complex benefit laws and claims issues once coverage is placed.

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