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Medicare Annual Enrollment Period coming up!

Discussion in 'TUG Lounge' started by simpsontruckdriver, Oct 10, 2019.

  1. simpsontruckdriver

    simpsontruckdriver Guest

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    One TINY tidbit of politics. A week or so, President Trump stated in "heaven's waiting room" (The Villages in Florida) that he is signing an executive order increasing plans and dropping prices for 2020. The problem is, at least one of the providers I sell dropped prices and increased plans in July! It's best to listen to an agent, NOT politicians.

    Anyway, it's time to sit down with an agent. AEP starts on October 15, but you can talk to an agent beforehand to go over what is new and such. You can enroll in a plan then, then if you change your mind find another, repeating if needed, but the plan you're "stuck with" is the one that you're enrolled in on December 7th at 23:59:59. Where I live/sell (Orlando area), I have insurers who sell Preferred Provider Organizations (PPO) for $0 premiums, in addition to HMOs and Medicare Supplements.

    TS
     
  2. elaine

    elaine TUG Member

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    question. Is someone just nothing, does their plan F supplement and drug coverage just automatically continue? If it's not being offered anymore, they would send notice, correct?
     
  3. simpsontruckdriver

    simpsontruckdriver Guest

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    Correct, all Medicare Advantage and Supplement Plans are Guaranteed Renewable. What that means is, unless your insurer says they are cancelling the plan, you will stay on it. Plan-F is no longer offered, so if the person cancels it, they lose it forever.

    So, if you are OK with what you have now, don't worry about it, just keep enjoying it! If you want to change your PDP (drug) plan, that will not affect your MediGap Plan F.

    TS
     
  4. Rolltydr

    Rolltydr TUG Member

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    Since this is, by its very nature, a travel site, a word of caution about Medicare Advantage plans. Study the plans very carefully. Many plans may restrict you to in-network providers and your network may be within your state lines. So, depending on your healthcare needs, MA may not be right for you. They can be very good plans and can save you some money but they can also be a problem if you need care while away from home. Original Medicare (A & B) does not have the in-network restrictions.


    Sent from my iPad using Tapatalk
     
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  5. simpsontruckdriver

    simpsontruckdriver Guest

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    In some areas, MAPD can also be PPO (Preferred Provider Organization), where you choose your providers at extra cost. Some MAPD HMOs like United and Humana allow you to go to in-network providers in another region, but only temporarily. ER, hospitalization, and dialysis are always covered out of region. Definitely ask if you plan on traveling next year!

    TS
     
  6. simpsontruckdriver

    simpsontruckdriver Guest

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    But here is the thing... DO NOT use the Medicare plan finder to compare plans. Talk to an agent. Every insurer (for me, Humana, Aetna, and United Healthcare) are telling agents that the revamped plan finder is giving bad numbers (total estimated costs). We can put in your drugs and such and give you correct numbers.

    TS
     
  7. rickandcindy23

    rickandcindy23 TUG Review Crew: Expert TUG Member

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    We are turning 64 in March and May, and we have already talked to the medical insurance we currently have, which is Kaiser.
     
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  8. simpsontruckdriver

    simpsontruckdriver Guest

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    If you're 64 now, start planning. Like, where do you stand with life insurance, retirement accounts, etc. Medicare is 64 yrs 9 months. If your group plan is better and/or cheaper than Medicare, you can delay taking it. If it is worse than Medicare, and you choose to delay it, you're liable for a life-long penalty based on how long from 65.

    For instance, my dad is 85, so he had Medicare for 20 years. In 2005, Part-D was introduced, he did not take the PDP. A year ago, he began having drugs covered, resulting in a lifetime Late Enrollment Penalty (LEP) for $40/month. I've heard of people also having a Part-A and/or Part-B LEP. Because my dad does not qualify for Low-Income Subsidy, he just has to pay it.

    TS
     
  9. artringwald

    artringwald TUG Member

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    The Advantage plans limit you to providers that are part of their network, although most have very large networks. The Medicare plan with supplemental works for all providers that accept Medicare no matter which state you're in when you need care. Medicare with all the supplemental options cost more/month, but has $0 copay and $0 deductibles. You never see any bills! Since we started on Medicare 5 years ago, we've had 5 joint replacement surgeries and didn't have to pay for anything except the prescriptions. For us, it certainly paid for itself.
     
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  10. bogey21

    bogey21 TUG Member

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    My take is that Standard Medicare with a Supplement and Plan D is a lot more flexible than most Advantage Plans but is more expensive. Some can easily afford to take this route, some can't...

    George
     
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  11. Talent312

    Talent312 Tug Review Crew: Rookie TUG Member

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    My issue with MA plans is that, if you try to switch back to original medicare:
    The supplemental plans don't have to take you and can bump up premiums.
    But if you choose a supplemental initially, you get standard renewal rates.

    DW is sticking with Plan F, although participants will age (driving up premiums).

    My State Employee Group insurance offers a Medicare plan, which I may take.
    It includes a much better drug plan than any standalone plan for Part D.
    For one brand-name drug I use, it's $240/year vs. ~$800 under a Part D plan.
    .
     
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  12. simpsontruckdriver

    simpsontruckdriver Guest

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    Another thing about supplements. You can leave your MAPD and switch to a MediGap plan and PDP during Annual Enrollment or Open Enrollment (01/01-03/31). On the other hand, if you decide to switch MediGap plans during the year, you're subject to underwriting, which usually means no pre-existing conditions are covered.

    Now, if you are under 65, disabled, and you have a MediGap plan, switching to an MAPD means you won't be able to get another MediGap plan until you hit 65.

    Back to MAPDs. If you currently have End-Stage Renal Disease (Kidney failure that needs dialysis and/or need a transplant), you can not get an MAPD. If you are on an MAPD and your kidneys die, you can switch to a MediGap, but it would probably be better to stick with your MAPD until your doctors say you're no longer ESRD. That is the only pre-existing conditions plan on MAPDs.

    TS
     
  13. Luanne

    Luanne TUG Review Crew: Veteran TUG Member

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    When I was close to 65 dh and I went and talked to our State Farm agent. He had sent me a letter. This meeting was very informational for me as he laid out all of the options. He did mention that State Farm has a Medicare Supplement Plan, but we were not pushed to buy it. Dh was already on Medicare and he went with a Supplement (F) through AARP and United Healthcare. When I turned 65 I went with the cheapest F plan I could find, which was a company called Old Surety. The advice I'd gotten from several people was, if you are going with a supplemental plan, go with the cheapest, as they are all the same (and have to be). Neither of us was interested in a Medicare Advantage Plan.

    So, my advice is, in addition to talking to who has your current medical insurance, look around and see what is available to you after you have decided which type of plan you want. There are independent insurance brokers out there who will help you find the cheapest one.
     
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  14. WinniWoman

    WinniWoman TUG Review Crew: Veteran TUG Member

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    From what I have read from other people, always check your Part D plan coverage- even if it is the same plan because suddenly you could be paying a lot more next year for the drugs you are on. So don't automatically renew before you check this out.

    I have also read some things about Humana renewing people into another plan and also trying to coerce people into Medicare Advantage plans. Be aware.
     
  15. Luanne

    Luanne TUG Review Crew: Veteran TUG Member

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    Another piece of advice I got was to be sure to get prescription coverage. Even if you don't need it when you take Medicare, you never know what will happen.
     
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  16. simpsontruckdriver

    simpsontruckdriver Guest

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    As a Humana (and Aetna and United Healthcare) agent, I never heard of where the company itself is doing any of those things, but agents doing it is possible. If that happens, the customer can call/write their state's insurance regulator, and most likely that agent will lose his license.

    On the other hand, SilverScript did that in 2012/2013. In 2013, Part-D recipients started going to pharmacies, finding out they now had a deductible. When the pharmacist and/or recipient looked at their plan, they saw the company changed them. In February of that year, Medicare came down like an Atomic Bomb on the company. They were fined a huge amount, they were not allowed to sign anyone up, and current members were allowed to switch to another company. They do not mess around!

    TS
     
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  17. Passepartout

    Passepartout TUG Review Crew: Veteran TUG Member

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    I can second this advice. We had never been big prescription users. A cheap thyroid drug for DW and some generic joint pain med for me. Period. We contemplated passing on Part D. Then in 2016, DW got an iron overload that quadrupled her spleen size, and leukemia. I had some lung issues and later, heart failure. Our drugs now total over $5,000 a month. Yes, we have a co-pay, but we are glad we signed up for part D when we started.
     
    Last edited: Oct 12, 2019
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  18. bogey21

    bogey21 TUG Member

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    This is good advice. My Part D Provider was acquired by Aetna and they are not only increasing my monthly premium but also raising the cost of the drugs I use...

    George
     
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  19. simpsontruckdriver

    simpsontruckdriver Guest

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    Regarding Part-D... if you're not going to take an MAPD (either not taking Part-B or you're taking a MediGap plan), and you're healthy, talk to an agent to get the least expensive PDP. Why pay $30+/month when you can get one as low as $15/month?

    TS
     
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  20. Brett

    Brett Guest

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    yes, it's medicare open enrollment season

    "A national network of State Health Insurance Assistance Programs (SHIPs) has trained counselors to offer local, personalized assistance to Medicare enrollees and their families. SHIPs can help answer questions about coverage, premiums, deductibles, coinsurance, or complaints and appeals. They can also advise you on joining or leaving a Medicare Advantage plan (similar to a health maintenance organization), any other Medicare plan or prescription drug plan.
    https://www.seniorsresourceguide.com/directories/National/SHIP/
     
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  21. WinniWoman

    WinniWoman TUG Review Crew: Veteran TUG Member

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    What is the best supplement plan now? I know it used to be F but that will not be offered anymore. We need to pick a plan for hubby to begin 1/1. We want the least out of pocket and want foreign travel covered, etc.

    I thought I read somewhere G was almost as good as F. F comes up when I go on the plan finder, but I think that is for people already on it and for 2019.
     
  22. simpsontruckdriver

    simpsontruckdriver Guest

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    Yes, Plan-G is the next best thing. You pay the Part-B deductible, then the MediGap pays 100%, not including Part-D (drugs). Yeah, it can be hard to get the premiums for MediGap plans, if you're interested talk to an agent.

    TS
     
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  23. WinniWoman

    WinniWoman TUG Review Crew: Veteran TUG Member

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    What about N?
     
  24. simpsontruckdriver

    simpsontruckdriver Guest

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    Since I am not licensed in New York (but I can be), I can say that here in Florida, the difference in price is $36/month less for Plan-N. The difference between Plan-G and Plan-N is "N" adds a doctor and ER copay. In other words, the $0 copay is only for hospital, rehab, diagnostics, etc. And all plans, whether MAPD or MedSupp, have a $0 copay for annual exams and low/no copays for certain vaccines.

    TS
     
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  25. pittle

    pittle Tug Review Crew: Rookie TUG Member

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    I will be calling Humana and changing our plans. Neither of us take prescription drugs, but had to choose one when we went on Medicare 7 years ago. (Never have used it.) Our plan started at $12 then and gradually went up. It went from $26.10 each in 2019 and now will be $56.30 each for 2020. I am signing us both up for the $13.20 plan. That will save us $1000 per year for something we do not use.

    We do have the AARP United Heathcare Plan F and will keep that for as long as we can.
     
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