Question from Art
Question from Art: Will the Medicare Annual Election Period over, will we get any relief from the commercials and incessant phone calls? And is there anything else those of us on Medicare need to be aware of in 2023?
Answer
Answer: I’m afraid they won’t stop Art. However, I can give some advice on how to avoid scams and keep yourself insulated from all the noise. First, ignore every solicitation that comes in the mail and commercial you see on TV. And never call an 800 number! If you receive unsolicited phone calls regarding Medicare, whoever dialed your number is in violation of the Center for Medicare and Medicaid (CMS) regulations. Get their name, phone number, and the companies they represent. Then report them to Medicare and those carriers. We can provide those phone numbers. The only way to stop these scam artists and scoundrels is for them to lose their appointments and licenses.
To help make the Medicare calls slow down and hopefully stop, go to donotcall.gov, the National Do Not Call Registry run by the Federal Trade Commission. You can register your home and cell phones and report unwanted calls on this site. If you have elderly parents, relatives, or neighbors, please help them do this. It’s people in their late 80’s and early 90’s who live alone that are most often victims of fraud. Remind them that no legitimate organization will ever call and ask for their Medicare, Social Security, or checking account number. Not Medicare themselves, Social Security, or their current insurance company who these criminals often impersonate.
As far as why the calls and commercials won’t stop, it’s because there’s another enrollment period that starts in January where people can still change from one Advantage Plan to another, which is what anyone on the other end of an 800 number or someone who called unsolicited will try and talk you into regardless if it’s in your best interest. The calls and ads may never stop because Advantage Plans that have a Five Star rating, which most in Western PA do, can be enrolled in all year long.
The enrollment period that starts January 1st may be more important than ever because so many people may have been talked into changing plans by an agent or broker whose only concern is making a commission. Often, they don’t explain the differences between Supplements or Advantage Plans properly or how one Advantage Plan can have much larger co-pays and MOOP than another. If you were talked into changing plans by an agent or broker who was not employed by The Health Insurance Store and want a second opinion, reach out to us.
I want to make something clear to HOP recipients. If you opted out of those benefits to enroll in a low-cost HMO or PPO Advantage Plan, you don’t have the same option of going back during the upcoming election period. I was really surprised how many people we heard from this AEP who get the $100 premium assistance opted out of their HOP Supplement, which I consider to be the best overall value in Medicare. You have until December 15th to contact HOP and change your mind.
As far as what those on Medicare need to be aware of for 2023, there are several items. Some good news is that the Shingles vaccine will be free to all those on Medicare next year. In the past, those on Advantage Plans paid between $37 and $47, while those on Stand Alone Part D as much as $250.
It’s particularly important I point out that those on Supplements who use Stand Alone Part D plans to get their medications have a $505 deductible on Tiers 3, 4, and 5. Many who have only taken generic medications don’t know this and are quite surprised when they get put on one and must pay for it up front before it’s covered on a co-pay basis. And since the average brand name drug now retails for $600 for a 30-day supply to around $1,000 for non-insulin injectable drugs, the Donut Hole comes into play quickly and is very costly.
There are ways to avoid both. Qualifying for PACENET is the simplest. Any single individual who makes $35,000 or less per year and any married couple under $45,000 qualifies. You must include the gross Social Security payments in this amount and assets have no factor in one’s eligibility.
Hundreds, if not thousands, of our clients who have Supplements and Stand-Alone Part D plans use Canadian pharmacies all year long. Eliquis, which is probably the most often prescribed drug in the US, can be purchased from Canada for as little as $72 for 168 tablets, just short of a 90-day supply. People who get it all year long from an accredited Canadian pharmacy are saving from $1,200 to $2,000 per year. The process of obtaining drugs from Canada is quite easy and convenient. Those who take Eliquis and have Advantage Plan HMOs or PPOs don’t have a drug deductible. However, they will hit the Donut Hole in August or earlier. They can then order from Canada prior to their cost increasing from around $40 to $150 for a 30-day supply.
Other commonly prescribed medications available in Canada at a lower price compared to what they are in the US include Jardiance, Januvia, Xarelto, Restasis, Symbicort, Advair, Breo, Spiriva, Premarin cream, and many more.
If you want to learn more about today’s column or make an appointment for a no-cost consultation in office, over the phone, or a virtual internet meeting, call us or email me personally. Aaron@getyourbestplan.com.
Get Your Part D Reviewed
Another mistake those on Supplements make is remaining on their Part D prescription plan without having it reviewed professionally, which should be done every year. Two of the most popular plans are almost doubling their premiums while not offering better coverage. It’s also common for drug tiers on plans to be moved from 1 to 2, 2 to 3, and so on. Failure to change Part D plans can be extremely costly. Even if you didn’t buy your Supplement from The Health Insurance Store, we can review and recommend a plan for 2023, just like we do for all our active clients. If you’re interested, please contact us as soon as possible so we can get you the necessary form.
There aren’t many significant changes to Advantage Plans, but indeed some items worth mentioning. Probably the biggest news is the reduction of the MOOP by one of our three major companies. In 2021 they raised it significantly across the board on all their plans to the maximum allowable by Medicare. It stayed the same in 2022 and many members chose other carriers due to the increase. However, on a select number of plans, including what we feel is their best for 2023, it has been reduced by $3,000 and is now the lowest in the market for those that supply prescription coverage.
If you weren’t aware, there are no preexisting condition clauses with Advantage Plans. Anyone who has Medicare Parts A and B can change plans or companies regardless of their current or prior health, even those who have End Stage Renal Disease. All Advantage Plan companies must accept you and begin to pay claims the 1st day the policy goes into effect. In addition, all Advantage Plans must cover the same categories of benefits. As I’ve written on so many occasions, paying more in premium doesn’t get you any additional coverage for medical services! In fact, we will not be advising our current or potential clients to choose any Advantage Plan that will have a premium above $40 per month in 2023. If you are paying over $40 for your HMO or PPO, you should call or email us to set up an appointment and see side by side why paying more doesn’t equal more.
How will Inflation Affect AEP?
Lastly, due to inflation, we’re expecting this AEP, which begins on October 15th, to be the busiest we’ve ever had in terms of moving people from Supplements to Advantage Plans out of financial necessity. If there was ever a good time to do that, now is it because the most competitive plans have never been better in the 15 years I’ve been in the Medicare industry. For those who don’t like the thought of leaving a Supplement, there is some good news. You may not have to as it appears one of the biggest increases in the Social Security Cost of Living Adjustment (COLA) is going to be announced soon. It’s estimated to be from 8.5% to almost 10%. And for once, the raise will not be eaten up by a large Part B premium increase. In fact, many people believe it’s going to remain $170.10.
AEP is right around the corner!
I’d like to remind readers that the Annual Election Period (AEP) is right around the corner. Pre AEP, when plan details are made public, starts October 1st and AEP, when changes to your plan lineup can be made and applications submitted, begins October 15th and runs through December 7th.
If you enjoy the columns, please consider using our no cost services when going on Medicare for the first time or looking at possibly making a change in plans as well as referring friends or family who are. Enrolling new clients in plans, which cost the same whether you use our free services or go directly through a company, helps us cover the expense of the articles so we can continue to run them every week. As brokers, we are appointed to provide plans from every competitive Advantage Plan and Supplement company in Western PA and West Virginia.
Thank you!
If you have any questions or concerns regarding this column topic, or would like to make an appointment for a no-cost consultation, please feel free to give us a call – we would be happy to help. I’d like to remind everyone that I do a live call-in talk show called Medicare A to Z every 1st and 3rd Monday of the month on WMBS Uniontown, 590AM and 101.1FM, from 1 to 3 PM. You can listen in on their website, wmbs590.com.
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