Get Ready: the Annual Enrollment Period Begins October 15th

October 15th is the beginning of the Annual Enrollment Period for Medicare Advantage plans and Medicare Part D prescription plans. If you have been on Medicare for a while and think this seems earlier than normal, you’re right.  Previously the annual enrollment period began November 15th and continued through December 31st. This year the period begins a month earlier, but it also ends earlier – December 7th.

 

The Annual Enrollment Period is important to all enrollees in Medicare Advantage plans and Medicare
Part D plans. Companies change their plans annually and will soon be sending enrollees details of their 2012 plans. This is the time to re-evaluate your current plan to make sure it is still appropriate for your needs. For Medicare
Advantage plans, be sure to review your 2012 plan’s:

  • Maximum-out-of-pocket amount
  • Daily inpatient hospital co-pay
  • Skilled nursing facility co-pay
  • Doctor and specialist co-pays
  • Diagnostic test co-pays
  • Outpatient surgery co-pays
  • Monthly premium
  • If your doctors remain in the plan’s network

 

For Part D plans and Medicare Advantage plans that include prescriptions, check your  plan’s :

  • Prescription formulary – are all your drugs included?’
  • Drug co-pays for the different tiers – how much have they changed?
  • Tier ranking of each of your drugs – have they changed?
  • Monthly premium
  • If your favorite pharmacy is still a preferred provider.

 

After reviewing your plan, if you want to see how it compares to other plans in your area, you can either go to www.medicare.gov or give us a call at 260-496-9229 and we will do a free review for you.

 

Remember, the Annual Enrollment Period ends December 7th. After that time the only change you can make is to dis-enroll from your Medicare Advantage plan and return to original Medicare with a stand-alone Medicare Part D plan.

The Cost of Caregiving and Long-term Care Insurance

The MetLife Mature Market Institute published a study in June, concerning the cost to employees to care for their aging parents. The results are alarming. Here are a few of their findings

 

• Nearly 10 million adult children over the age of 50 care for aging parents.
• The percentage of adults providing care for a parent has tripled since 1994.
• The average total cost to a working woman to care for her parents is $324,044.
• The average total cost to a working man to care for his parents is $283,716.
• Adult children age 50+ who work and provide care for a parent are more likely than who do
not provide care, to report their health is fair or poor.

 

How can long-term care insurance help? By providing the financial support to help pay for care giving, allowing the adult child to remain productive at work and at home. Long-term care insurance will not replace the need for the adult child to be with his/her parent. But it enhances the quality of time spent so the child can be with the parent, enjoying the time, rather than always be hurriedly doing things for them.

 

What if the parents do not have the resources to pay for insurance; should the adult child buy a policy for them? If the adult child, or the adult children, have the financial resources, it is worth considering. Long-term care insurance eases the decision making process, particularly when the children have differing opinions. Having the insurance policy pay for care is certainly easier than deciding which family member will give the lion’s share of money and time to care for their parents.

 

Today a couple asked me if I thought it was worth it to keep their long-term care insurance policy. My answer, “YES!” It is a gift to each other, and to their children, in the event one of them needs care.

“I’m afraid of Medicare Advantage plans. I hear the government is going to eliminate them and then what will I do?”

I hear that often–and it’s a legitimate concern. Medicare Advantage plans are mysterious and unknown to most people, and what they’ve heard from the Obama Administration is the plans are not good for seniors and should be eliminated.

 

So what’s the truth about Advantage plans and should they be considered a safe Medicare insurance option?

First, a little background. Medicare Advantage plans, sometimes called Medicare part C, originated with the Balanced Budget Act of 1997. The Act allowed Medicare recipients to opt for medical coverage from a private insurance company rather than the federal government. In 2003, Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act, which allowed the addition of prescription drug coverage. Once drugs were included in the plans, Medicare Advantage took off. Today more than 11 million people have Medicare Advantage plans and an increasing number of people have enrolled each year.

Why have millions of people signed up? They have the convenience of having one insurance plan that covers both medical and prescription needs. Plus, they pay low premiums when compared to Medicare Supplements. In fact, some Medicare Advantage plans have a $0 monthly premium.

 

Most people, when they hear ‘$0 premium’ ask, “What’s the catch?” The answer: There isn’t one. Medicare Advantage plans work because the federal government pays an insurance company to insure the Medicare recipient. However, therein lies a problem: the current administration is not a fan of paying insurance companies.

 

With original Medicare, the government insures Medicare recipients. The Obama administration believes it would be less expensive for the government to continue insuring Medicare recipients than to pay an insurance company to do it. So, with the Healthcare Reform Act, Medicare will begin gradually reducing what it pays to the insurance companies. The government’s intent is to increase the cost of Medicare Advantage plans to the recipients so Advantage Plans no longer have a cost advantage over original Medicare

 

Will the new Congress rescue Medicare Advantage plans? Maybe. Some Congressional Representatives have been working to make sure Medicare Advantage remains available in its current form. But with the pressure to reduce federal spending, it’s uncertain how effective their efforts will be.

 

So, back to our question, “Are Medicare Advantage plans a safe insurance option?” My current answer is yes. Although insurance companies have not yet released details of their 2012 plans, United Healthcare has already announced they will offer a $0 premium plan for next year without significantly reducing benefits. That’s good news. It indicates United Healthcare feels it can be very competitive in the marketplace and still make a profit. Other companies seem upbeat as well.

 

Medicare Advantage plans have offered consumers excellent health insurance in the past at a very affordable price. It appears it will again next year; and I expect 2012 will see enrollment in these plans continue to grow.

 

Will my answer be ‘yes’ next year? I believe so. I think Medicare Advantage plans will be here in the foreseeable future. I believe companies will continue to put together plans that will have advantages over original Medicare.

 

But let’s say I’m wrong and you are on a Medicare Advantage plan that decides to exit the market. You are guaranteed the ability to go back to original Medicare and obtain a Medicare Supplement without health questions. That sounds pretty darn safe to me.

If you’ve not tried a Medicare Advantage plan before, you can have a 12-month trial period to see if you like the plan. If not, you can go back to original Medicare and a Medicare Supplement, again, without having to answer health questions.

 

 

Keep in mind every individual is different. What is an ideal plan for your neighbor is not necessarily the best plan for you. If you have questions about Medicare Advantage plans, Medicare Supplements, and Medicare Part D prescription plans, give us a call at 260-496-9229. We’re here to help you find the best plan for you by making Medicare easy.