Medicare 2019 Open Enrollment starts on October 15th and ends on December the 7th. Who is affected? How do you decide what to keep and what to change? Where can you get answers to your questions?
Don’t get distracted by the hype.
During this open enrollment many will want to offer advice but how do you know their opinions are useful? Can you really get solid, unbiased advice or are you at the mercy of scoundrels?
Let’s set the record straight and give you some guidelines about what you need to know and how to sort out good advice from bad.
Medicare Open Enrollment 2019 – A Journey with a Purpose
Let’s start with the basics of Medicare 2019 open enrollment. One area that creates more confusion than anything else is changing Medicare supplement plans.
You can change your Medigap plan any time of the year. The annual enrollment period does not include Medicare supplement plans. Only Medicare Advantage and Part D drug plans are included in open enrollment.
There is generally only one time when you can buy a Medigap plan without answering health questions. For most folks that is when they turn 65 and enroll in Medicare for the first time. Once you have been enrolled in Medicare Part B for 6 months you can change plans as long as you pass through underwriting.
If you have questions about your ability to change plans, give us a call. In less than 5 minutes you can learn if you are healthy enough to be approved or not. We will also be glad to quote Medicare supplement rates over the phone and email you a Medigap rate report like this one.
If you can change your supplement plan at any time of the year, what do I need to know about Medicare Open Enrollment 2018?
Medicare open enrollment allows you to change your Part D prescription drug plan, or your Medicare Advantage plan. Neither require medical underwriting with one exception. If you are currently in renal failure you cannot change Advantage plans.
At Georgia Medicare Plans our focus is strictly on finding the best Medigap coverage that fits your needs and budget. We also offer detailed advice on Part D and will guide you through the enrollment process.
We do not offer Medicare Advantage plans but we will refer you to an associate if you are convinced Advantage plans are right for you.
Medicare Drug Plans are Confusing
The most difficult part of my work is helping clients find the right drug plan that delivers the best value. Let’s look at how I handled a review for a new client.
Bill currently takes two different medications to control his cholesterol, Ezetimibe and Xarelto. While was covered under a group health insurance plan his Xarelto copay was $0. That goes away once he is covered by Part D.
Bill likes to take charge of things and his own review of drug plans led him to believe his best option was a plan with a monthly premium of $55.
I felt he could do better.
Both of these drugs are expensive. Ezetimibe has a retail price of $300 for a 30 day supply; Xarelto is $400.
2019 update – Ezetimibe is currently $12 with a GoodRx discount.
Avoiding the Donut Hole
My analisys indicates he will enter the donut hole by the 4th month and his out of pocket drug costs will exceed $350 per month.
My suggestion was to drop Ezetimibe from his drug plan evaluation and purchase outside of Part D using GoodRx. His copay would be about the same as his drug plan but by removing the drug from the formulary calculation he is able to delay entering the donut hole to month 7 vs. the 4th month.
Can he avoid the donut hole completely?
As it turns out he can.
He can buy Ezetimibe through Blue Sky and lower his costs even more than using GoodRx. Before he enters the donut hole his Xarelto copay is $46. Once in the donut hole his copay more than triples. Copay’s for all drugs, not just the expensive ones, increases while in the donut hole. He can avoid the donut hole completely by purchasing his meds (except Ezetimibe) through the drug plan and then buying Xarelto from Blue Sky right before entering the donut hole.
Combining these suggestions he can choose a drug plan with a $22 monthly premium vs the $55 plan he would have picked on his own. Bill saves over $500 in prescription drug costs.
Medicare Drug Plans – Who is Advising You?
Where can you go for help and advice for drug plans during Medicare open enrollment 2018? Let’s run down the list.
- You can do it on your own
- You can call 1-800-MEDICARE
- Ask a friend what they have
- Choose the same plan you spouse has
- Talk to a volunteer at Georgia Cares
- Search online
- Ask an insurance agent
- Talk with your hair stylist
Obviously there are many choices but whatever route you take during Medicare open enrollment 2018 make sure you consider all of the following.
- Start with the Medicare plan finder even if you are going to ask for advice
- Next, record your Drug List ID number and Password Date for future reference
- Be sure to consider lower cost generics where possible
- Make sure you are including the lowest cost participating pharmacy’s*
- Check generic pricing using GoodRx
- Also check pricing at a Canadian pharmacy such as Blue Sky
- Include star ratings in your evaluation
- Don’t just assume the plan that worked well this year is your best choice for 2018
- If you use an agent, make sure they are looking at ALL available plans, not just the one that compensates them
- If you use 1-800-MEDICARE ask if they have suggestions on ways to save by purchasing drugs outside of Part D
- Sometimes free advice is worth what you paid for it
*In 2017 Walgreen’s often has the lowest prices for medications. If your evaluations for this year did not include Walgeen’s as an option you probably never saw the lowest priced drug plans. Low price pharmacy’s change every year. Make sure you don’t make the same mistake for 2018.
Look for Medicare Supplement Premium Savings
At Georgia Medicare Plans we do things other agents fail to do. If an agent fails to offer you a free Medigap rate report are they showing you the best options for you or only the plans that pay them the most money?
Every prospective client receives this report for the plan(s) they are considering. Just ask. It’s that simple. We email your report for review. Take time to study the report and form your questions. We are happy to help.
You have entered the “No Selling Zone”. Most of all, there is no pressure to buy but we do hope to earn your business. Call or email with questions, when you turn 65 or during the Medicare Open Enrollment 2019 dates.