It’s that time again: Medicare Annual Enrollment Period (AEP). From Oct. 15 through Dec 7th all Medicare-eligible individuals may change plans.
A quick place to preview those options can be found at. Here you can get an idea of the prices for Medicare Supplement plans aka Medigap plans, Medicare Advantage (Part C), or Prescription Drugs plans (Part D). This open enrollment period applies only to Part C & D.
Medicare Supplement plans have a limited change period during your birthday month.
Medicare cautions that the new Medicare Part D insulin benefits may not show in theirs or other websites. Starting 1/1/2023, you may not be charged than $35 for one month supply of Medicare Part D covered insulin and the cost may not be applied to your deductible.
If you are working with an insurance agent, you will notice some changes. All agents are required to record all Medicare related phone calls and maintain the recording for 10 years. They are not allowed to accept any of your Rx information over the phone.
You will also hear a new disclaimer that must be said in the first 60 seconds of the call. : “We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.”
This rule is new, so agents are implementing new systems to be compliant. As we all know, most new systems have glitches, so be patient with your agent and their phone system.
This rule is in response to the bad actors who use heavy handed sales techniques and often misrepresent the benefits of their plans. They will say that Medicare Advantage gives “additional benefits”. They talk about those benefits, but don’t discuss the lost benefits when an individual leaves a traditional Medicare supplement. In many cases, they are from a call bank outside the area and don’t realize that there are a limited amount of providers for Medicare Advantage Plans in the North State.
It’s always a good idea to review Part D Prescription Drug plans annually. Again, Plan Compare on the website can provide a personalized report based on current medications and show total cost, including deductible, premium and copays for each of the 26 plans available for 2023. Monthly premiums range from $4.50 to $172.50. “Humana Walmart had the biggest premium increase,” said agent Heath Withrow. “These folks will want to look at their plans for sure, but many will be able to continue without changing plans.”
Don’t assume that the more expensive plan is best for you. Each plan has different preferred pharmacies and formularies (approved drug lists). It’s important to see how your drug list is priced.
Of course, we are all one doctor visit away from a new Rx. Be sure to keep a copy of your formulary or the app, so your doctor can try to choose a medication that is covered well under your particular plan.
Discount cards like GoodRx and CleverRx or pharmacy sponsored cards can help reduce costs. Some people go through Canadian mail order pharmacies to fill their prescriptions and save more than 50% over the US cost. Obtaining a 90 day supply and paying attention to refill dates is critical if going out of the country.
Most agents work hard to help their clients with Rx plans during this short window and tend to limit client interviews to AEP business. Barbara McClaskey advises, “During the AEP, we will only be seeing clients that need to make changes to their Part D/Medicare Advantage Plan.” They are happy to see others after December 7.
Knowing that agents have to help almost their entire client base during about 8 weeks, puts a tremendous burden on those that serve Medicare clients. New rules, plans and systems make it quite trying. So be patient with your agent.
Also, be thorough with your drug list. Include the full name of the Rx, dosage and how often your refill it. If you have a preferred pharmacy, be sure to include the name. Expect to get more email from your agent with this new system. It will be more efficient. Insurers have online enrollment programs that can set you up from the comfort of home. Your agent will send an email link for enrollment, and you will maintain your personal agent, rather than some marketing call center from out of the area.
Don’t wait until Dec. 7th. Act now before the holidays close in. Most agents stop taking requests prior to that date because they know the insurers are overwhelmed and too many mistakes are made or applications lost.