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Medicare AEP Just Ended; What Now?

Medicare’s Annual Election Period (AEP) just ended on December 7. So what happens if you decide you need to change your plan later? Are you stuck with it until next October, when AEP opens back up again?

That depends upon which type of plan you have, and how your needs change. But in many cases, yes, you can make changes to your Medicare plan at other times of the year.

The Medicare Advantage Open Enrollment Period runs from January 1 until March 31. 

If you’re enrolled in a Medicare Advantage plan, you can make certain changes during the Open Enrollment Period beginning  January 1. If you decide that your current plan doesn’t fit you quite right, you can switch into another Medicare Advantage plan that better suits your needs or preferences. You can also drop the plan and go back to Original Medicare. If you take that course of action, you can add a Part D (prescription) plan to your Original Medicare.

However, those enrolled in Original Medicare can’t do anything during Medicare Advantage Open Enrollment.

You can qualify for Special Enrollment Periods throughout the year. 

If you qualify due to certain life circumstances, you could be eligible for a Special Enrollment Period at any point during the year. For example, if you move to a different coverage area, you can compare and change plans. Other circumstances, such as losing your current plan, your current plan changes its contract with Medicare, or you become eligible for employer-sponsored coverage can also serve as qualifying events.

In fact, many circumstances can qualify you for a Special Enrollment Period, so when in doubt, ask! Call one of our Medicare specialists to discuss your changing needs, and we can help you determine if you are eligible to make changes to your Medicare plan outside of AEP or OEP.

Take Action NOW Before Medicare’s Annual Election Period Ends

Have you reviewed and updated your Medicare plan yet? If not, this notice is for you: Medicare’s Annual Election Period ends on December 7. That means time is running out to evaluate your current plan, decide if it still suits you, and compare it with other plans to determine if a better option is available.

Even if you like your current plan, you should take action. If you do nothing during the Annual Election Period, you will be re-enrolled into your current plan for 2022. However, you  should read your Annual Notice of Change carefully. Plan administrators can and do issue changes to Medicare plans each year, and sometimes those changes can be significant. We don’t want you to confront an unpleasant surprise next year if you discover that your plan no longer works well for you.

If you can’t find the Annual Notice of Change that you should have received in September, that’s okay. Give us a call and we will help you learn about any upcoming changes to your plan.

Here’s what you can do during Medicare’s Annual Election Period. At this time, you have the opportunity to learn about your current plan, and compare it with the rates and coverage of other plans that are available to you. This is the time to find the best healthcare plan for your situation. During Medicare AEP you can:

  • Drop your Original Medicare and enroll in a Medicare Advantage plan instead
  • Switch from one Advantage plan to another Advantage plan
  • Drop Medicare Advantage and go back to Original Medicare
  • Add a Part D (prescription) plan, change from one Part D plan to another, or drop Part D

Help is available. There is never any charge or obligation for speaking to a Medicare specialist. Call us to discuss your Medicare plan options, and we can help you evaluate your current plan and learn about other options available to you. But remember: The deadline for making changes to your plan is December 7, so let’s get started today. 

Avoid These Three Medicare Enrollment Mistakes

Medicare’s Annual Election Period is happening now. We understand the temptation to make quick decisions and get the process over with. After all, comparing and analyzing health insurance plans isn’t exactly anyone’s idea of fun! But try not to be too hasty, and watch out for these three common Medicare enrollment mistakes.

Don’t automatically re-enroll in your Part D plan. Once you’ve selected a Part D (prescription) plan, don’t assume that the same plan will always work well for you. The plan’s formulary (list of covered drugs) can change each year. Out-of-pocket expenses can shift as well. Unfortunately, you can’t opt into a Part D plan once and then assume it will fit your needs forever.

Each year during the Annual Election Period, review your plan’s formulary and out-of-pocket charges, and compare it with other Part D plans that are available to you. You might find a better deal elsewhere.

Don’t assume that you and your spouse need the same plan. Just because your spouse’s plan works well for them, does not mean that it will work just right for you. You are individuals, with your own healthcare needs and priorities. Assess each of your plans as individuals, paying close attention to details such as physicians and facilities covered by the network, and the plan’s drug formulary. Choose plans that fit each of your needs best.

Don’t forget to check the network. If you opt for a Medicare Advantage plan, remember that these plans work within a network of approved providers. And each year, that network can change. So before you enroll or re-enroll in a Medicare Advantage plan, double check to be sure your preferred physicians and facilities will be included on the plan’s network for the following year.

And of course, if you have any questions or concerns about the Medicare enrollment process, do give us a call. Help is free, so you might as well utilize the guidance of a Medicare insurance professional.

What Happens if You Need to Make Changes to Your Medicare Plan After AEP?

This year’s Medicare Annual Election Period (AEP) is underway now, and lasts until December 7. At this time you can make changes to your Medicare plan. Or, if you do nothing, your current plan will automatically renew.

But what if you realize that you need to make changes to your Medicare plan at some other time of the year. Are you just stuck with whatever plan you have, until AEP reopens next fall? Or can you make changes some other way, and how do you do that?

Yes, there is actually another time that you can make certain changes to your Medicare plan, depending upon your circumstances. From January 1 until March 31, the Medicare Advantage Open Enrollment Period (OEP) will allow you to make the following changes:

  • Drop your Medicare Advantage plan and go back to Original Medicare
  • Enroll in a Part D (prescription) plan, if you took the above step
  • Switch from one Medicare Advantage plan to another Advantage plan

But there’s one thing you cannot do during OEP from January through March: Those enrolled in Original Medicare plans cannot switch to an Advantage plan.

Outside of the OEP window, you can make changes to your Medicare plan by accessing a Special Enrollment Period, assuming you meet certain criteria. Those criteria are numerous, but in most cases fall under one of the following conditions:

  • You move to a new plan service area
  • You move into, or out of, a long-term nursing facility
  • You qualify for Special Help
  • You receive both Medicare and Medicaid benefits

Certain other conditions can help you to qualify for a Special Enrollment Period. When in doubt, just ask! Call us if you need to make changes to your Medicare plan outside of AEP or OEP, and we can help you discover whether you might have a qualifying condition. But do remember that AEP happens for a reason each fall. Take a look at your current plan now, and consider whether a different Medicare plan would better suit your needs so that you don’t suffer any regrets next year.


Covered California Open Enrollment Is Approaching

For those of you who are already enrolled in a healthcare plan through Covered California, as well as those who wish to enroll for the first time, pay attention to this important date. On November 1, Open Enrollment begins. Now is the time to analyze your budget and ask yourself about your priorities in a healthcare plan, so that you’re ready to conduct some comparison shopping next month.

First, let’s review what you can do during Open Enrollment:

Enroll in a new plan. Those of you who are not yet covered by a healthcare plan can enroll for the first time during Open Enrollment.

Compare your current plan, and choose a different one if desired. Everyone should review their current plan to discover whether any changes will be made that affect you. For example, if your network is changing or covered drugs have been dropped from the plan’s formulary, you might wish to switch to a healthcare plan that better suits your needs.

Even those who feel satisfied with their current plan should engage in a bit of comparison. You won’t know if a better deal is out there, unless you look!

Apply for a subsidy. If you need help with the cost of your healthcare premiums, apply for a subsidy. These tax credits apply to those with incomes between 128 percent and 400 percent of the federal poverty level. A subsidy can help you to afford a healthcare plan or even upgrade into a higher tier plan that you might not otherwise choose.

Renew your subsidy. If you’re already receiving a subsidy, you should log onto the Covered California portal to update your information. Taking this step ensures that your subsidy is calculated correctly.

Enroll in Medi-Cal. Those whose annual incomes fall below 128 percent of the federal poverty level can enroll in Medi-Cal (Medicaid in California).

Open Enrollment will begin November 1, 2021, and run through January 31, 2022. However, if you wish for your new healthcare coverage to start on January 1, make sure you enroll by December 15. If you have any questions about Covered California, don’t hesitate to contact our office and we’ll be happy to assist you.

Understanding the Difference Between a Medicare Advantage Plan and a Medicare Supplement Plan

Contrary to common belief, you won’t just enroll in Medicare at 65 and then be done with it. Actually, Medicare encompasses many different parts, and there are even Medicare options offered by private insurance companies.  Putting together the right plan, or combination of plans, will help you to manage your healthcare expenses throughout retirement. Plus, each year you have the opportunity to change your Medicare plan during Medicare’s Annual Election Period.

So as you confront that maze of decisions, you will start to learn about the different types of Medicare plans out there. One common question that we hear a lot is, “What is the difference between a Medicare Advantage Plan and a Medicare Supplement Plan?”

A Medicare Advantage Plan is simply an insurance plan, offered by a private insurance company, that complies with certain standards set forth by Medicare. These plans operate based upon a network of providers and facilities, and might feel similar to the healthcare plan you enjoyed pre-retirement. They all encompass Medicare Parts A and B, and some also include Part D (prescription drug) coverage.

A Medicare Supplement Plan, or Medigap plan,  is designed for those who enroll in Original Medicare (Parts A and B) to help them manage out-of-pocket expenses. A Supplement Plan covers out-of-pocket expenses like your co-pays and deductibles, and even some uncovered services such as healthcare that you receive when traveling outside of the country. This type of plan can be a good option for those who want to stick with Original Medicare, but are worried about fluctuating out-of-pocket expenses. You cannot use a Supplement Plan with Medicare Advantage.

Hopefully that clears up the issue for you! But if you have any other questions about the different types of Medicare plans available to you, just give us a call. And remember, Medicare’s Annual Election Period begins on October 15. Get ready to make a decision about your healthcare plan for 2022.


7 Things Medicare Does Not Cover

As we plan for retirement, most of us expect that Medicare will provide for our healthcare needs. And yes, you will become eligible for Medicare when you turn 65, around the time many people choose to retire. But contrary to popular belief, Medicare will not necessarily cover everything you might need with regard to healthcare! It’s important to understand the limitations of the program, so that you can make a plan to pay for these items in some other way.

Dental. Generally speaking, Medicare does not cover dental exams and procedures. The program also does not cover dentures. However, some Medicare Advantage plans include dental coverage, and a supplemental plan might be another option for you.

Vision. Medicare will cover treatment for medical problems with your eyes, such as cataracts. But you will need to self pay for routine vision exams and corrective lenses, or look into a supplemental vision insurance program. Some Medicare Advantage plans do include this coverage, but those plans might not be available in all areas.

Cosmetic surgery. With regard to cosmetic surgery, Medicare will only cover reconstructive procedures related to an injury or illness. For elective cosmetic treatments, you’re on your own.

Podiatry. Some podiatry services are covered by Medicare, while others are not. Check your plan carefully before visiting a podiatrist, and make a plan to pay for uncovered expenses.

Hearing aids. Original Medicare will not cover hearing exams or hearing aids, but does cover medical treatments relating to the ears. Some Medicare Advantage plans do include hearing aid coverage, or you can look into one of the newly approved over-the-counter hearing aids that will soon be available.

Nursing homes. Medicare coverage for rehabilitative treatment in a facility is quite limited. If you need to move into a nursing facility in the long term, you will be responsible for that expense. Look into long-term nursing care insurance as you prepare for retirement.

Medical care received in other countries. If you plan to travel outside of the country, you might be interested to know that Medicare will not cover the cost of medical treatments received abroad. A Medigap policy can provide for this need.

In some cases, Medicare Advantage plans provide more comprehensive coverage than Original Medicare. But because each plan is different, we recommend that you work with us to identify a policy that best suits your needs. Continue to prepare for retirement, understanding that you will need to self pay for some medical services.

What You Can And Cannot Do During Medicare AEP

Medicare’s Annual Enrollment Period is rapidly approaching, and will begin on October 15. At this point you might be wondering what you can do during Medicare AEP. And on the other hand, it can be helpful to know what you cannot do, so that you understand the limitations of the program. So here’s what you need to know right now.

What you can do during Medicare Annual Enrollment Period:

  • Drop Original Medicare and enroll in a Medicare Advantage plan instead
  • Drop your Medicare Advantage plan and go back to Original Medicare
  • Compare costs of different Medicare Advantage plans to identify one that better suits your needs
  • Change from one Medicare Advantage plan to another
  • Add a Part D (prescription) plan to Original Medicare, drop a Part D plan, or switch from one Part D plan to another

If your plan provider is making changes to your current plan, they will send you an annual notice of change in the mail. Look for this notice, so that you can anticipate upcoming changes and switch plans if necessary. Even if you’re happy with your current plan, it makes sense to compare with different options to be sure you’re enrolled in the best plan for your needs and budget.

That’s pretty comprehensive. But there is one thing that you cannot do during Medicare Annual Enrollment Period: This is not the time to enroll in a Medigap plan. The Medigap Open Enrollment Period is a six-month period of time that starts when you first become eligible for Medicare. During this time, you can enroll in a Medigap plan without answering any questions about your health. Later, you can drop your Medigap plan and enroll in a new one, but you have to pass underwriting first. There are no guarantees that you will be eligible for a new or different Medigap plan outside of the original Open Enrollment window, so the time to make this important decision is during your original Open Enrollment Period.

Remember, Medicare’s Annual Enrollment Period begins October 15 and runs through December 7. Call us for more information, and we can help guide you through this process.



3 Questions to Ask About Your Medicare Plan

The Medicare Annual Election Period is approaching fast, and will begin October 15. This is your chance to review both your plan and your budget, to determine whether your current plan is the best fit for your needs.

Medicare plans are complex, and you might need assistance to determine which one suits you. But asking yourself these three questions can get you started toward making this very important decision.

Is my doctor part of my plan’s network? Medicare Advantage plans are organized around networks of providers, whereas Original Medicare and Medicare Supplement plans allow you to visit any provider that accepts Medicare.

Network coverage can sometimes change from one year to the next. So if you prefer a Medicare Advantage plan, check to be sure that your preferred facilities and doctors are covered under your plan. If not, we can help you locate a plan that does offer that coverage.

Do I need prescription drug coverage? Original Medicare doesn’t include prescription drug coverage, but you can enroll in a Part D plan to cover that need. Many Medicare Advantage plans do include Part D coverage, however. If you take prescription drugs regularly, it is likely that a Part D plan will benefit you. Check your plan’s formulary, keeping in mind that it can change each year, to determine whether it provides for your needs. Comparing several plans can help you locate the one that provides appropriate coverage.

What is my healthcare budget? How much can you afford to pay for out-of-pocket expenses like premiums, co-pays, and deductibles? Has your current plan helped you to manage expenses well, or do you prefer to shop for a plan with lower out-of-pocket costs? Numerous options are available to help you fit healthcare into your budget.

Give us a call, and we’ll help you assess your current coverage and any impeding changes to your plan that might affect you. Then, together we can compare Medicare plans to see if we can locate a better fit for both your finances and healthcare needs.

4 Things that Will Prepare You for Open Enrollment

At this point in the summer, health insurance might be the last thing you’re thinking about. But because Open Enrollment is really just a few months away, now is the time to begin evaluating satisfaction with your current plan.

Plus, due to the pandemic and increased need for healthcare coverage, Covered California is actually operating a Special Enrollment period for the duration of 2021. So if you’re dissatisfied with your current healthcare plan or still haven’t enrolled in one, you can take care of that important step right now!

Here’s what you need to know, before shopping for a healthcare plan:

Consider your location. Healthcare plans are location-based, meaning every plan isn’t offered in every location. So don’t assume that you can get the same plan that your friend 100 miles away enjoys. And since your location influences the plans offered in your area, take a look around at local providers. Decide where you prefer to receive healthcare services, and look for a plan that includes those doctors and facilities within its network.

If you’re planning a move, as many people have over the past year or so, healthcare access and plan availability should be part of your decision process.

Learn the tiers. Healthcare plans are arranged in tiers, called Bronze, Silver, Gold, and Platinum, according to coverage and out-of-pocket expenses. Bronze plans impose the lowest monthly premiums but have the highest deductibles. At the other end of the spectrum, Platinum plans charge the highest monthly premiums but have the lowest deductibles.

Don’t assume that low premiums will translate into the lowest expenditure for the year. Everyone’s needs are different, and someone who uses healthcare services frequently might be better served by a lower-deductible plan.

But if you do choose a low-premium, high-deductible plan, consider pairing it with a health savings account. This account allows you to set aside pre-tax earnings to be used toward your deductible and other out-of-pocket expenses.

Apply for subsidies. Subsidies are calculated according to your income and household size, and can help to offset the cost of your premiums. You might qualify for more than you think.

Get help. Choosing a healthcare plan is a complicated decision that will impact your finances over the next year. Call us for expert guidance, and we can help you understand all of the complexities of each plan before selecting one that best suits your needs.





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