The 2020 Medicare open enrollment period is fast approaching.  It runs from October 15th through December 7th – plan changes will not be effective until January 2021. Our agents are busy training so we can discuss important new plan benefits, costs and features.

In insurance speak, this period of time is also referred to as the Annual Election Period or AEP for short. It is the one time during the year when certain insurance changes can be made for Medicare beneficiaries.

Allowable Insurance Changes During AEP

There are several changes Medicare beneficiaries can make during the 2020 Medicare open enrollment window:

1. Changing Medicare Advantage Plans
2. Enrolling in a new Prescription Part D Drug Plan
3. Leaving Medicare Advantage to rejoin Original Medicare
4. Leaving Original Medicare to join a Medicare Advantage Plan
5. Shopping for less expensive Medicare Supplement coverage

If this if your first AEP, it may seem confusing, but if you’re happy with your current insurance coverage, there is nothing that you need to do. The list above is only stating your options.

The most important advice to keep in mind is following the rules. Enrolling in some plans will make you ineligible for others. Missing certain dates can also have consequences. It is a good idea to work with a knowledgeable agent or agency (like ours) if you are considering any of the above. There is no cost to do so.

Switching Medicare Advantage Coverage During AEP

If you are already enrolled in Medicare Advantage Prescription Drug (MAPD) coverage, you can shop for and enroll in similar coverage with another (or the same) carrier if you find a plan that better meets your needs. Sometime plans change year over year and there are plans that reduce your premiums and/or out of pocket exposure. Other times a new plan might offer a better network of doctors and hospitals.

We can help you compare plans starting October 1st, but enrollment must take place between Oct. 15th and Dec. 7th. Your new coverage will become effective as of January 1st 2021.

It is important to learn all the details of any new coverage you might be considering. Medicare Advantage plans can differ quite a bit. That is to say a PFFS plan will differ from a HMO, PPO or Medical Savings Account. And you’ll also want to ask how any changes will affect your prescription drug coverage.

And some plans offer new benefits like a free gym membership, rides to your healthcare provider, meals during recovery periods and/or dental and vision insurance. There’s a lot to compare

Purchasing A New Prescription Part D Plan

Your options for changing Part D coverage may differ depending on whether you are enrolled in a Medicare Advantage or Medicare Supplement plan. Some Advantage plans offer drug coverage and some do not.

If you are considering changing your Part D coverage, you will want to make sure it does not affect any MA (Medicare Advantage) plan you are considering. Enrolling in a stand-alone Part D plan can automatically dis-enroll you from some MA plans!

By rule, all Medicare supplements sold today do not offer drug coverage. Typically, prescription Part D policies are offered on a stand-alone basis. They are separate from traditional Medicare supplements life Plans F, G, and N. Changing to a new Part D plan will have no effect on your Medicare Supplement plan.

Finally, there can be penalties for those who enroll late in Part D drug coverage. If you’re not sure about how enrollment deadlines personally affect you, then contact us.

Leaving Or Joining Original Medicare A & B

During the 2020 Medicare AEP open enrollment window, you can leave original FFS (Fee for Service) Medicare to join a Medicare Advantage plan.

You can also plan leave your MA plan to rejoin FFS Medicare A & B and purchase a stand alone Part D plan.

Either change will become effective January 1, 2021.

There are several reasons you might consider making either of these changes and each decision has its own ramifications. This is not to say one is better than the other, rather that it’s important to know how these changes affect your ability to enroll in other types of Medicare insurance.

The ins and outs of the two scenarios above can be somewhat complex. If you are considering either for the first time, please make sure you understand how that might affect your ability to make changes the following year. It’s best to talk with someone who does this on a daily basis. It’s easy to make mistakes.

Shopping For A New Medicare Supplement Plan

If you are currently enrolled in a traditional Medicare supplement insurance plan and shopping for lower rates, then the 2020 Medicare open enrollment window will have little bearing on your options.

In most states, you can change Medicare supplements any time you wish. The process will be the same as insurance companies will require some amount of medical underwriting to prove you are insurable.

In some states (like MO and CA) there are specific, individual yearly anniversary periods when you can switch Medicare supplement insurance coverage without medical underwriting. These states are the exceptions to the rule. Most times, you must pass medical underwriting to switch to a plan with lower premiums.

The Annual Election Period does not provide you with a window to purchase a new Medicare supplement without medical underwriting. And this is the time of year when Medicare supplement prices are typically going up for the next year. Thus, it can be advantageous to shop for and change your supplemental coverage before the fall season when possible.

2020 Medicare Open Enrollment Assistance

Hyers and Associates is an independent insurance agency specializing in Medicare insurance policies of all kinds. We work in several states and are licensed with many, many insurance companies.

If you are unsure of your options during the 2020 Medicare open enrollment window, then  contact us. We will be happy to help you compare plans and advise you on your options.

Currently, there are approximately 66 million Americans enrolled in Medicare. And that number is climbing daily.

Medicare is a government-backed health insurance program helping those 65 and older afford health care. However, it does not cover all of your expenses.

You’ll usually want to supplement your coverage. Unless you have group, retirement coverage, or VA Benefits, this means you’ll want to compare Medicare Supplements to Medicare Advantage plans.

The Case For Medicare Advantage Plans

Medicare Advantage is one way to round out your Medicare benefits. Medicare Advantage insurance is private, but includes coverage for Vision Insurance, Dental Insurance, Hearing Insurance, and qualified Wellness Programs, such as Silver Sneakers.

They can also cover expenses such as transportation to doctor’s visits, over-the-counter medications, and adult daycare services. These policies can even be found for $0 a month. They are affordable and help close many gaps for seniors.

However, there can be network restrictions as these plans are usually HMOs and PPOs. And your out-of-pocket exposure can be higher for hospital stays and other medical expenses.

The Case For Medicare Supplement Insurance

Medicare Supplements, or Medigap, are another great way to help you pay for out-of-pocket expenses not covered by Medicare, such as deductibles, copayments, and coinsurance.

There are 10 different plan options, the most popular of which are Plans F, G, and N. All three offer the most comprehensive coverage.

There are no networks to worry about. You can see any doctor or hospital that accepts Medicare. And you have very little out-of-pocket exposure with most Medicare Supplement policies. There will be less to pay when you go to the doctor or require hospitalization.

Which Coverage Should I Choose?

While you may say, “that’s great, I’ll take both!”, unfortunately, you are only eligible to choose one or the other.

Because of that, one question that may better serve you is, “What’s the cost difference between Medicare Advantage and Medigap?”

1. Medicare Advantage plans usually have lower premiums, but may not have as broad of coverage. This results in more out-of-pocket expenses.
2. Medigap offers more expansive coverage across the United States, as well as more flexibility with out-of-network physicians. Medigap makes it very easy to file a claim, but often has higher premiums.

However, Medicare Advantage policies offer prescription drug coverage with most plans, where Medigap users must purchase separate Stand Alone Part D coverage.

Contact Us With Questions

Which is better? The answer is not the same for everyone. Some may benefit more from a Supplement while others save money with an Advantage plan.

One size does not fit all. A lot depends on your utilization and overall health. And you’ll want to know how your decision today affects your options for change tomorrow. There’s a lot to know!

Hyers & Associates can help you work through the options. Call or request a no-cost, virtual appointment today!

It’s the time of year when Medicare announces changes that affect Medicare beneficiaries and the insurance plans they own.  Like most years, the 2020 changes are incremental, but larger than what we saw for 2019.  We will discuss them below and how they will affect your out of pocket exposure.

(It’s important to note that when the officials at CMS (Centers for Medicare and Medicaid Services) make changes, it affects all insurance plans – both new and old.  It doesn’t matter when you purchased your coverage – all plans must abide by any new cost sharing rules.)

2020 Medicare Premiums, Deductibles & Coinsurance

Medicare Part B Premiums in 2020

Medicare Part B premiums will be increasing for many Medicare beneficiaries in 2020 due to the increase in Social Security monthly payments.

Those who fall under the “hold-harmless” provision, by rule, must have their Part B premiums offset by increases in Social Security payments. Some will have their premiums raised to $144.60 a month while others will see smaller increases based on a sliding scale.

Those who are new to Medicare in 2020 will pay $144.60 per month – a $9.10 increase from 2019. This amount will be more for high income earners. The Income Related Monthly Adjustment Amount (IRMAA) requires individuals making more than $85,000 – and couples filing jointly making over $170,000 – to pay more for Part B coverage. There are four tiers to the IRMAA payment schedule. You can view them here.

Medicare Part A and Part B Deductibles

Most of our clients ask about the Medicare Part B deductible each year. The good news: The Medicare Part B deductible for 2020 is $198 – a $13 increase from 2019. This is an important amount for those who own Medicare supplements not covering the Part B deductible – like Plan G and Plan N.

Plans G and N continue to be some of our most popular policies because of the small Part B deductible. In many cases, the lower premiums with G and N more than make up for the deductible and/or office copay amounts.

Like most years, the Part A deductible (Inpatient Hospital Care) is only increasing slightly to $1,408 – a year over year increase of $44. Most Medicare supplements cover the Part A deductible, so this figure is not quite as important. The most popular policies, Plans F, G and N, all cover this gap.

What is the 2020 Plan G & Plan F High Deductible Amount?

High Deductible Plan F and G are also popular due to their low premiums and known out of pocket exposure. The deductible will only be increasing slightly to $2,340 in 2020. That’s a modest $40 increase from 2019.

Plan F, G and J are the only plans currently offered that come in a high deductible version. Plan J hasn’t been available for many years – and Plan F will only be available for those who were Medicare eligible before 2020.

High Deductible Plan G will be the only plan available for those who are new to Medicare in 2020 and beyond. In many states, HD Plan G will offer the lowest monthly premiums of any Medicare supplement for sale.

Medicare Supplement Plans K and L Maximums

Plans K and L were introduced in 2010 as part of the Medicare Modernization Act. In our minds, these plans most closely resemble Medicare Advantage policies. They have larger out of pocket exposure than more traditional plans like F, G and N. Unlike Medicare Advantage, Plans K and L do not have network restrictions, however.

CMS announced moderate increases for 2020 to the out of pocket maximums for these two unique plans. The out of pocket will be $5,880 for Plan K and $2,940 for Plan L.  We don’t see a lot of interest in these two plans at out agent as others (including many Advantage plans) offer more value when comparing benefits and costs.

Contact Us For Quotes And Assistance

We are a full service, independent insurance agency. We license direct with all of our carriers and can help you enroll (at no additional cost) with the Medicare insurance plan the best fits your needs and budget.

We work with many, many carriers offering Medicare supplement, Medicare Advantage and Part D prescription drug coverage. Contact us today to compare your best options.

Compare Medicare Insurance Quotes Today  →

Medicare Open Enrollment for 2020 effective dates has begun. This window runs from October 15th through December 7th.  All changes to your Medicare Advantage and/or Prescription Drug Part D coverage will take effect January 1, 2020.

Should you miss the Annual Election Period (AEP) open enrollment window, it may not be possible to make changes until this time next year. It’s important to review your coverage and make sure your benefits, costs, copays and network availability are still in-line with your needs.

What Are My Options During The Medicare Open Enrollment Window?

There are several changes you can make to your Medicare coverage during the AEP window.  You can:

• Switch to a new Part D prescription drug plan
• Enroll in a new Medicare Advantage Plan
• Disenroll from a Medicare Advantage Plan and return to Original Medicare
• Compare and shop for Medicare Supplement Insurance

As you probably know, Medicare is full or rules and timelines. It’s usually a good idea to talk with a knowledgeable agent this time of year. Changing Medicare Advantage plans or enrolling into (or out of) an Advantage plan for the first time can be tricky. You’ll want to make sure you follow the Medicare guidelines so as not to incur penalties and/or delays.

Lowest Priced Part D Prescription Drug Plan For 2020

One of the most common changes this time of year is purchasing a new stand-alone Medicare Part D Drug plan. Medicare drug plans can change dramatically year over year and this year is no exception. You don’t want to assume your premiums, copays and deductibles will be the same. They won’t.

There are some significant changes for 2020 – more so than most years. WellCare has purchased Aetna’s book of business. Aetna has, in-turn, partnered with SilverScript. And Humana has introduced a new Walmart Drug plan. But if you have the old Humana Walmart plan, you will not automatically be mapped into the new one! In fact, you’ll be moved into a different plan with premiums that are twice as high. That change may not work well for a lot of consumers.

This year, more than ever, it’s important to check your options with several major changes happening. You may want to create an account at MyMedicare and plug-in your prescriptions. Or you may want to speak with an experienced agent if you’ve never shopped for a new Part D drug plan before.

There are several new competitively priced Part D plans for 2020. Aetna, Envision, Humana and Wellcare all have plans with inexpensive premiums, robust formularies and low copays on most generic drugs. Your best option may depend on which pharmacy you prefer. Mail order will be a good option with many of these plans as well. Make sure to review your ANOC for (Annual Notice of Changes) and then research all of the new plans for 2020.

There will be other comprehensive low cost plans offered from SilverScript, Anthem BCBS and United Healthcare. But remember you don’t want to shop on premiums alone. Copays are one of the most important factors in determining your best option for 2020. It’s best to shop by lowest overall cost. This method factors in your premiums, copays and the deductible all at once.

Switching Medicare Advantage During Open Enrollment

Medicare Advantage plans can and will change year over year. Many will adjust their premiums, drug coverage costs, health benefits and networks. A plan can have a $0 premium one year and increase the next. It’s wise to review all of your options each year – especially if you experienced higher than expected out of pocket costs during 2019.

We help our clients shop for new Medicare Advantage coverage each year. If you are unhappy with your plan for any reason, then the Open Enrollment window is the best (and sometimes only) time to make changes.

It’s comforting to know that we see more competition and better coverage from Medicare Advantage plans almost every year. In some counties, you might have over 40 plans to choose from. It’s wise to compare them all with an agent to see if one has lower prescription costs and/or better access to the doctors and hospitals you prefer.

Additionally, the government has loosened the reins on many Advantage providers. Many companies are offering new ancillary benefits, like: dental, vision & hearing coverage as well as rider services, wellness visits, gym memberships, free meals during recovery, and much more. While these are not reason alone to buy an Advantage plan, they can put some policies ahead of another.

Leaving Your Medicare Advantage Plan

This change can be a little tricky. There are several factors that will help determine your best course of action. Most people who drop a Medicare Advantage plan will also want to purchase a Medicare supplement and/or a stand-alone Part D Drug plan.

In almost all cases, Medicare supplement carriers will require medical underwriting if you’ve been in an Advantage plan longer than 1 year. This means you can be turned down. Your acceptance depends on how long you’ve had your Medicare Advantage plan, what type of insurance you have previously, and your overall health. You don’t want to assume you’ll be automatically accepted for a Medicare supplement policy.

The good news is you should have no trouble enrolling in a Part D drug plan when making this change. In almost all cases, those can be purchased on a guaranteed acceptance basis with no underwriting. You just need to make your choice by December 7th. After that, the Open Enrollment window is closed until next year.

Our brokerage can help you understand your options when disenrolling from a Medicare Advantage plan and returning to Original Medicare. If you have some health issues, there may be some Medicare supplement providers who will accept you – and others who won’t. We can help find the companies that may make this transition possible.

What About Changing Medicare Supplement Insurance?

Unless you live in certain states like California and Missouri, there is no open enrollment window for Medicare supplement coverage. If you want to change Medigap plans, in most cases you will need to pass medical underwriting. This usually consists of answering yes/no questions on the application and a phone interview with a medical underwriter. You won’t need to see your doctor. At the end, you can be turned down for any number of health concerns.

In other words, you can try to change your Medicare supplement insurance any time you want so long as you are able to pass medical underwriting. A lot of consumers wait until AEP to shop for better rates on these policies, but this change can be done throughout the year. We encourage our clients to call us year round to see if they can qualify for lower rates.

Applying for a new Medicare supplement during Open Enrollment does not guarantee acceptance like it does with Medicare Advantage and Part D plans. It’s best to shop while you are in good health and/or when you get a rate increase during the year.

Our Independent Medicare Focused Insurance Agency

We offer Medicare supplement, Advantage and Part D insurance policies direct from several carriers all across the country. There are no fees whatsoever to use our services. Contact us today to discuss your best Medicare options for 2020.

When you’re Medicare eligible, you’re likely deciding how to best supplement your coverage. Should you choose a Medicare Supplement or a Medicare Advantage plan?

A good argument can be made for both, but for the purposes of this article we’ll explain why many of our clients choose a traditional Medicare supplement plan. Also referred to as Medigap policies, these plans (like F, G, & N) work with Original Medicare as oppose to replacing it.

1) No Network Restrictions With Supplements

The primary reason many of our clients enroll in a Medicare supplement is to avoid the hassle of network restrictions. When you choose a supplement, you can see any doctor or hospital that accepts Medicare. Your supplement will not in any way determine who you can see – or where you can receive care.

Medicare Advantage plans work differently. Most of these policies are HMOs and PPOs.  In other words, they have networks you need to use in order to keep your medical costs down. If you go out of network, you’ll pay more. And in some cases, out of network care may not be covered at all. Additionally, some Advantage plans require a referral from your Primary Care Physician to see a specialist.

Since Medicare Supplements have no networks to worry about (they simply start paying after Medicare stops), they’re convenient for those who travel frequently within the U.S. They can also be more suitable for those who have second homes in other states. With a supplement, you never need preapproval to go see any doctor or hospital that accepts Original Medicare.

2) You Have Limited Out Of Pocket Exposure

The other nice feature Medicare supplements provide is predictability. With almost all of these plans, you’ll know exactly what your out-of-pocket exposure is for the year. The most commonly purchased policies (like Plans G, N and F) only have a couple of hundred dollars that you are responsible for each year – if that. Then your supplement covers the rest of any Medicare approved expenses you might encounter.

Medicare Advantage plans have much higher out-of-pocket exposure for the insured. It’s not uncommon to see yearly out-of-pocket maximums in the $5,000 – $10,000 range. Your exposure will depend on what plan you choose (HMO, PPO, or PFFS) and whether you are in (or out of) network for your care. It’s much harder to predict, but the cost-sharing is much higher with most Advantage plans.

3) You’re Tailoring Your Coverage To Fit Your Needs

You’ll here many insurance companies refer to Medicare Advantage plans as, “All in One” policies.  That’s because they privately insure you for what Medicare Parts A and B cover – while also filling in some of the gaps in A and B. On top of that, many of the policies include Part D drug coverage and some dental and vision insurance.

But some of our clients like to tailor their Medicare insurance coverage to their needs. This means selecting the Medicare Supplement that’s best for them, choosing a separate Part D drug plan that best covers their specific prescriptions, then choosing a comprehensive dental and vision plan that their providers accept.

Sometimes an Advantage plan can work well for some of these part, but not all of them. Maybe they don’t have a favorable copay on a particular prescription – or one of your doctors is not in the plan’s network. While you usually pay more when purchasing each piece separately, you have the peace of mind knowing that all parts should be a better fit overall.

And there are a handful of plans available that offer a free Silver Sneakers gym membership. This is a great way to stay healthy and in shape while not needing to spend more money on memberships.

Contact Us To Compare All Of Your Medicare Options

Still not sure? Read our article on the top three reasons to choose a Medicare Advantage plan and then contact us with questions. Hyers and Associates is an independent insurance brokerage specializing in Supplements, Advantage, and Part D Drug plans.

We can help you compare all of your options so you can find the insurance coverage that best suits your needs and budget!