With the Medicare Annual Enrollment Period coming, what’s the best advice for those already on Medicare? 

Question: With the Medicare Annual Enrollment Period right around the corner, what is the best advice you can give those of us already on Medicare? 

Answer: Welcome to Part 8 and last of my Medicare Reset Series designed to prepare those on Medicare for the Annual Enrollment Period (AEP) that starts on October 15^th and runs through December 7^th. AEP is the only time of the year when those on Medicare can make any and all changes to their plan lineup. 

If you’re just seeing the series for the first time, I highly recommend reading it from the beginning. You can find all prior editions on our Facebook Group, Ask the Medicare Specialist, or our website, www.GetYourBestPlan.com.  

I want to once again separate this edition into two parts, one for those on Medicare Advantage Plans and the other for those who have Supplements. It’s necessary to do that because cost, coverage, and how both types of plans work with Medicare are very different. 

Before getting into my specific and detailed advice, you can make the process of determining if your current plan is best or if there are other options that will offer better value next year in terms of premiums and out of pocket costs less confusing by reaching out to us at The Health Insurance Store. We’re brokers, appointed to represent every competitive Advantage Plan and Supplement company on the market, ensuring unbiased advice. And consultations are always no cost! We’ve been helping people make sense of Medicare since 2008!

Advantage Plans Advice

• Open and read every piece of mail that comes from your Advantage Plan carrier this time of year! This is when you will be warned if your plan is terminating, a doctor or hospital will be removed from your network, or a drug you’re currently taking will no longer be covered or moving to a higher tier. You will also get a book called the Annual Notification of Change (ANOC). There are a couple pages in this document that show the increases in co-pays or premiums and changes in benefits for 2027.  
• Shop your plan! Just because you’ve been on your plan for years doesn't make it competitive! Plans can change dramatically year to year and 2026 and 2027 will combine to be the most significant in terms of people being saddled with more increased out of pocket costs and reductions in ancillary benefits such as dental coverage than in any other two-year period since The Health Insurance opened in 2008. Don’t let fear of change cost you thousands of dollars in out-of-pocket costs and premiums. This is the most common and expensive mistake those on Advantage Plans make.
• Do your best to avoid plans with expensive per day hospital co-pays of that can total $1,500 to 2,000 or more for each stay! The most likely scenario where people meet and pay their annual Maximum Out of Pocket Limit (MOOP) is having multiple hospital stays that cost $1,500 and up. 
• If you can’t avoid high per day hospital co-pays, look for a plan with the lowest MOOP. There can be thousands of dollars difference in MOOP between companies and plans. 
• Although it is not the case in Western Pennsylvania, all over the country there are Advantage Plans that aren’t paying agents commissions, which means agents and even the insurance companies themselves won’t present them as an option even when they might be the best choice. Go to Medicare.gov to see every plan available in your zip code and make sure all your options are being presented. 
• As I mentioned, over 1 million people are having their Medicare Plans terminated. This provides a one-time opportunity to be approved for a Medicare Supplement regardless of your current or previous health issues using what are known as Guarantee Issue (GI) rights. If you are losing your Advantage Plan, I can’t stress enough how important it is to consider using what may be your last chance ever to get a Supplement. If you run into an agent or someone at a company who tries to minimize this opportunity or tells you it would be too expensive and not worth considering, find someone else to work with.  
• Advantage Plans are changing and not for the better. Many, maybe even most Advantage Plans now have huge hospital co-pays as much as $2,800 as well as a $700 drug deductible and higher prescription co-pays. The extras like grocery and OTC allowances along with comprehensive dental benefits are being eliminated or dramatically decreased. I’m predicting that higher out of pocket costs and premiums will continue to be the norm in years to come. Therefore, it’s my recommendation for anyone who can pass medical underwriting and can afford a Supplement to learn about how they eliminate the stress of annual benefit changes and losing access to local doctors and hospitals while making receiving care easier. Consider moving to a Supplement while you still can until we see how Advantage Plans shake out over the next few years. 
• Anyone who calls you unsolicited doesn’t have your best interest in mind! Neither your current carrier nor Medicare will call you unscheduled to do a “plan review to make sure you’re getting all the benefits you’re entitled to.” Hang up on anyone who calls you and talks like that! 

Supplements (Medigap)

• You need to understand that all Supplements with the same letter are identical regardless of what company sells it! Plan G is G is G and N is N is N regardless. What’s covered is the same, how claims are approved and paid are the same, and access to doctors and hospitals is the same. Cost is the only difference between companies selling the same letter plan! Don’t get caught up in being fearful that if you change companies something might not be covered! That can’t happen and it’s the most common and expensive mistake people on Supplements make. 
• Those who are on expensive and antiquated letter Plans C, F, and G and can pass medical underwriting need to move to either Plan N or Innovative G. I’ve done the math. People 70 years and older who are currently on Plan G will pay $20,000 more in premiums than those the same age who have Plan N over the next 10 years if there is a 12% annual rate increase on both plans! There is almost no difference in out-of-pocket costs between G and N. Get educated on what Excess Charges are and why it’s an antiquated benefit. You’ve been told by agents and others who don’t understand Excess Charges that covering them is necessary. It’s not! Don’t spend $20,000 over the next 10 years to cover a benefit you will never use and two small co-pays!
• If you still insist on keeping Plan C, F, or G, shop the same plan with another carrier. You can often save hundreds, if not thousands of dollars per year by keeping the same letter plan but changing companies. 
• Do not enroll or renew in a Part D plan that costs over $35/month in 2027.  85% or more people on Supplements are best to enroll in a Part D plan that has a premium under $10 for 2027! You don’t need to pay more for a Part D plan out of fear the less expensive plans won’t cover drugs you may be prescribed later! There are protections in place so any drug that is prescribed must be filled immediately among other regulations. You can see my tutorial on how to shop and compare Part D plans. Click this link to watch it. https://youtu.be/UzQcsrfKz08?si=4n-VCmKgu6nzLkQk 

If you have questions you would like answered by one of our experienced agents, or to make an appointment for the Medicare AEP, give us a call, 724-603-3403 or email me, Aaron@GetYourBestPlan.com.