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2021 Medicare Annual Enrollment starts on October 15! [MERGED]

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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. Unlike Group and ACA ("ObamaCare") plans, all Medicare plans are Guaranteed Renewable. What that means is, unless your insurer says they are cancelling the plan, you will stay on it. And in many locations, you have a choice of MAPDs, you can get an HMO (restricted) or a PPO. 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! Some have an HMO POS network, meaning you must choose in-network doctors BUT there are no referrals.

For Medicare Supplements, your enrollment window (Guaranteed Issue) is 2 months before your birthday, birth month, and 2 months after, as well as Annual Enrollment. 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 (very few states allow disabled MAPD members to switch to a MediGap plan). Unlike MAPDs which are regulated by the federal government, supplements are regulated by the state. Many states have either Issue Age (your premium is based on the age when you sign up) or Attained Age (premiums go up every year).

Then, there is the matter of Prescription Drugs (Part-D). No matter what, you MUST have either a MAPD or a Part-D plan once you get Medicare, you have 63 days from your first eligible month to sign up or else you will be charged 1% per month every month you do not have creditable Rx coverage. For example, if you did not have an Rx for 102 months, you're essentially paying $40-ish Late Enrollment Penalty + premiums for life. If you are disabled and don't take Part-D, everything resets at 65.

There are plenty of Special Enrollment Periods (SEP) throughout the year, and if there is a natural disaster in your area, Medicare may add one. The disaster ones extend your current enrollment period. So, let's say your birthday enrollment period ends this month and your area gets hit with a hurricane. CMS ("Medicare") would specify how long you have. But, if you don't qualify for an SEP when the disaster declaration is issued, that does not give you one.

If you currently make less than $19000 per year, you may qualify for Social Security Extra Help. They will eliminate any late enrollment penalties, erase the "Coverage Gap" (you pay the same for each tier of drugs until reaching the Catastrophic Phase), and possibly erase Part-B and/or Part-D premiums. Agents like myself suggest anyone having $$$ issues go ahead and apply, there may be state assistance available.

I think I covered it, definitely ask for more information! We can pretty much stop adding to my original post, that is last year's news!

TS
 
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Then, there are those with Medicare (or about to get it) who have Diabetes and require Insulin. You may have heard you can get it for $35 in 2021. Sounds good, right? Well, there's a catch! Medicare Advantage and PDPs must have at least one group for $35. For instance, one insurer may have the long-lasting version at $35, one may have the bottle (where you buy your own needles and select how much), another insurer may have the "pen", it is up to the insurer. If you take Insulin and it costs more than $35, talk to your agent about finding a plan that offers your version of Insulin for that much. I have not found one that covers ALL Insulin products for $35, but I can be wrong.

TS
 
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FYI, CMS (aka "Medicare") has raised 2021 Part-B premium to $148.50. Apparently, thanks to Medicare paying a HUGE amount due to Seniors who contracted Coronavirus, the premium was set to be $160/month. Congress set a cap for the next several years.

TS
 
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One Medicare SEP many do not know of is moving. If you are moving outside your zip code, you should change your MAPD plan. Your new zip code probably does not have your current plan, even if they do you and your agent may find a better one.

As a side note, I just recently added a state, so I am now licensed in Florida, North Carolina, Washington (state), and California.

TS
 

Talent312

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Having original Medicare (+Medigap), I'm looking at stand-alone Drug Plans (Part D).
The Medicare plan compare site helps to ID lower cost plans, but some $$ are wrong.

I suggest using company website for Part D plans you're considering for accurate $$.
For me, Clear Spring had been #1, until I saw their own $$ were MT Medicare's $$.
.
 
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In my 2020 Medicare post (about 9 pages long), I mentioned that Medicare's Part-D plan comparison site was giving bad information. That is also why I HIGHLY suggest getting with an agent to compare costs, whether MAPD, MediGap and/or Part-D. It costs you nothing! Let us do the dirty work, we'll give you the costs and compare with your current plan.

TS
 

Patri

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I can't wait until the enrollment period is over. I am so tired of the commercials by Joe Namath. He has nice dentures or veneers, though.
 

Patri

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duplicated itself
 
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I've seen retirees complain on Medicare's Facebook page about his commercials. Actually, he is not advertising for Medicare, he is advertising for a call center that handles several Medicare Advantage insurers. Anyway, insurers won't end their commercials at the end of Annual Enrollment (December 7), they will only air less. After all, January 1 - March 31 is Open Enrollment, where everyone who has an MAPD has one more opportunity to change, BUT insurers can not advertise it (unless the law changes within the next month). Then, insurers switches to those who are new to Medicare, moving, or have a Low-Income Subsidy, which are the most common reasons for getting retirees to sign up.

TS
 

Patri

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I'm also upset with Tom Selleck for his annoying commercials pushing the elderly to buy reverse mortgages. The wording has changed from the original ad way back. He and the company must have gotten negative feedback about taking advantage of people, so they are justifying the rationale and making it seem so normal. After all, someone a dead husband coached recommended a RM to his widow.
 
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IN ADDITION, many areas of the United States have plans that GIVE YOU MONEY! If you have an agent (I can assist if not), you can ask them if one of these HMO plans are available in your area. For instance, in Florida, Humana and a couple state-only MAPD insurers give customers $75-$100 per month. If you pay $148/month for your Part-B, you will now pay $48-$73 per month. The only catches are (1) you have Parts A & B and live in the area, and (2) willing to accept the HMO's terms.

Here is a "dirty little secret" about HMOs. Let's say you have a PPO or MediGap, but you want to pay less than $100/month for full-feature HMO insurance. Your agent can find out if your PCP and specialists accept the "rebate" plan. Go ahead and sign up. When the plan takes effect in January, go to your PCP for an annual exam. Give your specialists' names to your PCP and have them write up the referrals. That is less work for your PCP, you took all his work! Your insurer will accept the referrals since both your PCP and specialists accept that HMO plan. If the specialist does not accept that HMO plan, the insurer will reject it and your PCP will need to do another referral. Insurers won't tell you that, agents may or may not tell you that, but it will happen.

TS
 
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Here are the official CMS 2021 Medicare costs for those without an MAPD:
  • Part B Premium is $148.50 (or higher depending on income) an increase of $3.90
  • Part B Deductible is $203 an increase of $5
  • Part A Premium (if applicable) is $471 ($259 for 30-39 quarters) an increase of $13 ($7 for 30-39 quarters). Premium is $0 if you have 40 quarters of work.
  • Part A Deductible is $1,484 deductible for each benefit period an increase of $76
TS
 

bluehende

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I am in the process of picking my medigap insurance. It seems that the best available to me for my situation are plans N, G and D.

The cheapest and of course covers less is the plan N. I am using this for the base.

Plan D has no co-pay for part b

plan G has no co-pay and also covers any excess Dr fees on part b.

This seems to be the only differences. Can any experts out there correct me or verify this is true. It is hard to quantify how much excess fees drs will charge. My benefits advisor said this was pretty rare that this happens.

For those that will be planning in the future and want numbers.

The copay is 20 bucks.
The costs for me at this point are plan g is 128 a month. plan d is 118, and plan n is 108
 

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When I applied, the cost of premium for Any supplement covering the Part B copay, costs more than that copay. And although it continues to rise I believe it is still under $200. I am pro Supplement over Advantage plans, but do be aware, the premiums continue to rise.
 

bluehende

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When I applied, the cost of premium for Any supplement covering the Part B copay, costs more than that copay. And although it continues to rise I believe it is still under $200. I am pro Supplement over Advantage plans, but do be aware, the premiums continue to rise.
I am going through my old employers benefits manager so they may be a little cheaper by negotiation. And for some strange reason I could get the plan g through someone else for 218. Highmark for the same plan is much cheaper than cigna.
 

isisdave

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We have N.
The excess charge can only be up to 15%. But some states prohibit them. We live in CA and have never seen one.
The deductible for part B this year is $204, so paying $10 a month more for Plan D vs Plan N makes sense even if you go to the doctor just a few times. The cost difference was greater on ours.

Today's the last day of open enrollment.

There's a good comparison tool at https://www.ehealthmedicareplans.com/
 
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bbodb1

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I am not looking forward to figuring this out for us. Still have some time, but it is coming...

Best of luck with this @bluehende .
 

bluehende

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We have N.
The excess charge can only be up to 15%. But some states prohibit them. We live in CA and have never seen one.
The deductible for part B this year is $204, so paying $10 a month more for Plan D vs Plan N makes sense even if you go to the doctor just a few times. The cost difference was greater on ours.

Today's the last day of open enrollment.

There's a good comparison tool at https://www.ehealthmedicareplans.com/
This is initial enrollment so have a bit longer.
 

bogey21

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I am in the process of picking my medigap insurance. It seems that the best available to me for my situation are plans N, G and D.
For almost 20 years I have been enrolled in High Deductible Plan F which is no longer available to new enrollees but I think there is now a High Deductible Plan G. My deductible is rather high. I think it is something like $2,300. But if the amounts that Medicare doesn't pay on your bills is small like mine have been, it works fine. Every year I have saved more on the premium differential between Regular Plan F and High Deductible Plan F than I have paid out of pocket...

George
 

WVBaker

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I am not looking forward to figuring this out for us. Still have some time, but it is coming...

Best of luck with this @bluehende .
Just another joy of getting old. ;)
 

Talent312

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My state (Florida)'s Office of Insurance Regulation has a rate-search engine.
You put in your county and plan (G), and it lists each company's premiums.

I chose three companies and asked my doc's billing clerk for her preference.
She said United HeathCare (AARP)... not the cheapest, but nearly so...
 
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One thing to remember: Medicare Supplements' premiums either MAY go up or WILL go up, depending on your state. Medicare Advantage plans are regulated by Medicare (Supplement plans are regulated by your state) and most have zero premiums. Some states are Issue-Age, where your premiums MAY go up every year, the insurer must get the OK from the state to raise premiums for all their members. Other states are Attained-Age, where your premiums WILL go up every year. Unlike Medicare Advantage enrollment period, a Medicare Supplement Guaranteed Issue timeframe is 2 months before and 2 months after your 65th birth month. If you're disabled and you're signing up for Medicare before 65, you can join a Medicare Supplement once, but if you drop it and go to an MAPD, you can not get another Supplement until you turn 65.

Todd S
Licensed Health Insurance Agent in FL, CA, WA, and NC
 
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As a side note, Medicare Annual Enrollment Period has ended. You're eligible to change ONLY if you have a Special Enrollment Period like moving residences, moving in/out of a skilled nursing facility, gained/lost Low-Income Subsidy. There is a CHANCE CMS (Medicare) may extend the AEP due to Coronavirus, but I doubt it since Medicare recipients knew since October 15th that they could switch.

TS
 
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