All posts by Debbie Sears

2019 Medicare Annual Enrollment

Medicare, Part D

Here are some dates and deadlines you’re going to want to know. Starting October 15, we were able to sell Medicare advantage and prescription drug plans (PDP) for 2019. And this period ends December 7 of 2018 for your 2019 plan choices. And January 1, whatever plan you’ve chosen becomes effective.

My best advice to you is know more about your prescription drug plan. Generally speaking, your Medicare supplement rolls from one year to the next with consistency and predictability on how that will perform; however, if you choose to make a change in that regard, this is your window of time to do that.

There are pros and cons to every choice that is presented to any of us. The real differences between Medicare advantage plan and supplements. Please call me with your questions. On the prescription drug plans, this might warrant an annual check-up. How I determine what plan a person should carry is accessing a list of your prescription drugs including the dosage and frequency. Enter that list into a quote prescription drug calculator and the end result will make this crystal clear. The end result consists of monthly premium, deductible (if any), the tiering of every drug on your list, the over the counter drugs (OTC), it will show co-insurances, co-pays and your true out of pocket (TROOP). Consequently, you can see in black and white Choice 1 and Choice 2 and the bottom line. Before you go to the drug counter, you will have an idea as to what your expenses should look like. Once you place that, you are good until next year. Throughout the year, your prescription drug plan could be revised by your medical providers or drug companies, could make changes in their formularies. It’s just a good idea this time of year to run that through a checkup. And then you are good to go.

2019 Under 65 Open Enrollment

Open Enrollment, Retirement

Heads up, everybody! The open enrollment period for persons under age 65 for your 2019 health insurance plans starts November 1 and runs to December 15. You’ve got a couple weeks to get yourself positioned for January 1 of 2019. If you do not enroll in a 2019 plan by December 15, you cannot enroll in a health insurance plan for 2019 unless you qualify for a special enrollment period (SEP).

If you are planning to retire at age 62, don’t do it until you know what your next step is going to be for your health insurance. Perhaps you have a spouse who is still employed. Know the benefits and know the prices. Do you intend to work part time? Some large employers are considering hiring some employees for benefits. What do you have in mind? There is a gap between retiring at age 62 and attaining Medicare eligibility age which is typically 65 years old. Please call me. Most of the time this is a determining link to the puzzle.

New Medicare ID Cards

Uncategorized

The process has already begun to remove social security numbers from Medicare cards to prevent fraud, prevent identity theft and keep tax-payer dollars safe. These new cards will be mailed from April 2018 – April 2019.

Your new Medicare health insurance card (your red, white and blue card) will have a scrambled identification number containing letters and numbers (HICN – Health Insurance Claim Number). The process is a national process and the United States has been divided into regions and each region is having a different beginning date so that there is a wave of mailings going on across the US.

If you’re talking to your best friend in Pennsylvania and they already have their card and you don’t, don’t panic. Yours will be coming soon. When you get your new card, please take your old one out of your wallet – it won’t work. Don’t throw it away – destroy it. The idea is to protect your identify from theft.

How do you know if you need to change your Medicare or Pharmacy plan?

Health Insurance

One thing I encourage people to pay attention to is their pharmacy needs.

Our pharmaceutical costs have been skyrocketing for years and it seems that the utilization increases, seldom, does a person have the privilege of taking a drug off their list of medications.

Within the calendar year, pharmaceuticals can be reclassified. What that means to you is a Tier-3 drug could be changed to a Tier-2, etc. That will change what you’re expected to pay at the cash register.

My advice is to run your pharmacy drug list through our online drug calculator and it will tell us bottom-line on each plan the dollars that you should expect to pay, therefore, you will know if you need to make a change or not. You will also have things like EOC (evidence of coverage) and you’re also going to have ANOC (annual notice of change) that are going to be very confusing to you. Just call me and I’ll help you navigate the alphabet soup of healthcare. Information on next year’s plans will be available after October 1.

https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-help-others/Medicare-Open-Enrollment.html

What Is OEP?

Health Insurance

Now that I’ve told you what the annual enrollment period is, let me tell you want Open Enrollment is.

Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs.

Call me with questions.

The Alphabet Soup of Healthcare

Health Insurance

You will hear acronyms all the time and you’re going to constantly be listening to the conversation and at the same time splitting your attention between what is the IEP and what is the OEP. Let me help you with this. Here is a cheat sheet.

AEP is an enrollment period as defined by Medicare between the dates of October 15 and December 7. If you didn’t sign up when you first became eligible for Medicare during your IEP (your initial enrollment period), the AEP is generally your first chance to make changes unless you qualify for the SEP (which is the special enrollment period).

Let’s go back to the AEP. Here’s a link to the Centers for Medicare and Medicaid Services. This link will have accurate updated information for you to reference anything from Medicare to Medicaid, regulations, etc. It’s easy to navigate and then call me with any questions you have. I’ll be happy to help.

Part D Medicare (PDP)

Medicare, Part D

Medicare Part D prescription drug pans were designed to help you manage your drug costs. What we have available at the moment are the 2018 choices and I’ve attached the link. The reason for the link: we do not have marketing material available to us until October 1.

My intention is to get you thinking about what needs to be done because our open enrollment period is very limited, from October 15 – December 7; however, in this link, you will learn about what Medicare Blue Rx can offer you and the two plans you see here. It is my suspicion that these will be very similar for 2019.

There is a tool called a “cost estimator” which I use to answer your prescription drug name and dosage to determine which one of these two plans best fits your prescription drug list. At the end of that process, the print out will illustrate the bottom line for each choice and include your monthly premium, annual deductible and your co-pay and co-insurance costs for your specific drug list.

I like to use Wellmark’s MedicareBlue Rx plan because it has been awarded a 5-star rating from CMS. This is the highest possible score which is why this continues to be a top choice for the members. Please scroll down to the bottom of the attachment and read about the 5-star rating. It is to your advantage to have this quality in place. Please give me a call anytime October 1 going forward. I am here to help you.

Medicare Open Enrollment

Medicare

Anybody that is Medicare enrolled or Medicare eligible needs to know that the Medicare open enrollment period every year is October 15 – December 7. This is the window of time that the Federal government has set aside for you to make your planned election for effective date January 1, 2019.

We can start marketing product October 1 (I can start answering your questions October 1 going forward) and we can start writing policies on October 15. You can change your health plan and your prescription drug plan if it is necessary to do so. I strongly encourage you to be pro-active about educating yourself on where you want to be for January. This window of time goes quickly and we cannot make changes past the dates that are already in place per the Centers for Medicare and Medicaid services (CMS). I am attaching this link for your convenience. If you want to read about it. Please don’t hesitate to contact me. I’m here to help.

https://www.wellmark.com/blue/medicare-supplement/enrollment-errors

Federal Laws and Guidelines

Health Insurance

As we come up to the end of the year, many groups are going to renew. Here are some matters of fact that would help you understand some federal laws and guidelines and some state laws and guidelines.

I would like to start with, “What is COBRA”. To put this in a nutshell, COBRA, “Consolidated Omnibus Budget Reconciliation Act”, is a federal law that allows members of an employer-sponsored health plan immediate coverage under certain circumstances. As an employer, you need to adhere to the federal COBRA laws. As an insurance agent, I am not allowed to be involved with your COBRA benefits. This law falls under the Department of Labor and the accountability is between the employer and the federal government. As your insurance agent, I try to educate you on this, make suggestions so your liability as an employer is well-protected and the administration of these COBRA plans are done per the timelines and guidelines set forth by the federal government. Some of this you may not have an interest in knowing, however, I’m doing an injustice to you by not letting you know that it exists and if you’re not compliant with it, the liability is yours as the employer.

This link is to the Department of Labor’s website for your convenience. If you want to bookmark this and refer to it from time to time, you will have it. With the employer group plans that we sell and service, you have the option, for a very nominal fee, to have the insurance company handle all of your COBRA enrollments, mailings and dis-enrollments on a partnership basis, so you do some of the work as the employer, the company does some of the work as the insurance company. I highly recommend that this be part of your employer-sponsored health plan.