Medicare Open Enrollment 2019

Medicare Open Enrollment 2019. Shop Medicare supplement plans and Part D. New, lower Medigap premiums. Are higher drug costs coming in 2019?

Who is invited? Who should stay home?

Can anyone help navigate the Medicare maze?


Medicare Open Enrollment 2019

So much information. So much confusion. Medicare Open Enrollment is not for everyone, and certainly not for the faint of heat.

If you think you already have all the answers, don’t read this post. If you believe Medicare open enrollment is for everyone you will probably learn something.

Medicare AEP is not a casual stroll. For most people, this is the only time you can change your Part D drug plan or Medicare Advantage plan.

Make a mistake and you will have to live with that decision for a year.


Be Prepared

Before you enter the annual election period, do this.

  • Make a list of all doctors including name, address, phone.
  • List all area hospitals, especially the ones you have used.
  • Make a list of all medications including dosage, refills, prescribing doctor and pharmacy.

Be aware of the donut hole and look for ways to avoid that trap. Make use of generics and off plan purchases.

Look for FDA approved generics and ask your doctor before making a change.


Part D Jungle

If renewing, get your drug list ID and password date from your last drug plan finder.

If renewing, study your ANOC for changes.

Use for reviewing Advantage and drug plan options.

Avoid using for PDP comparisons prior to October 25.


Review Medicare Supplement Options and the GA DOI site is essentially useless when comparing Medicare supplement options.

Most Medigap quote engines only list a handful of options and rarely have plans with the best value

Many quoting sites will sell your information to numerous agents; some don’t provide instant quotes

Never put anything on auto-renew unless you like unpleasant surprises.


Understand the Differences

Both Medigap and Advantage plans cover the same types of medical treatment, but what you pay out of pocket for your care, and where you receive your care, is very different.

Advantage plans are managed care plans. Some are PPO, some are HMO. In 2018 about half the plans are HMO with the balance being PPO.

If you receive non-emergency out of network care under a PPO you may have higher copay’s and deductibles. Your max OOP may also be higher. Some plans do not cap out of network charges.

Non-emergency out of network care charges may be denied if you have an HMO.


Medicare Advantage Considerations and Cancer

In 2018 most Advantage plans issued in Georgia limit your out of pocket for approved in network health care expenses to $6700.

The American Cancer Society tells us that more than half the 1.4 million new cancer diagnoses occur in people age 65 and older. Roughly 20% of retiree deaths are a result of cancer. Medicare pays for almost half of the $74 billion spent on cancer treatment. The elderly account for 70% of cancer deaths each year.

Some cancer centers, such as Mayo Clinic and MD Anderson do not participate in Medicare Advantage plans.

Not all cancer responds to chemotherapy, but 80% of cancers are treated with chemo. Those treatments occur in an outpatient setting and are covered under Medicare Part B.

Chemotherapy drugs administered in a doctor’s office or clinic normally fall under Part B. Medication from a retail pharmacy or by mail fall under your PDP.

This is why most of us chose a Medicare supplement plan in 2018. Bob Vineyard, independent Medicare insurance broker in Georgia, can explain your Georgia Medicare insurance options and will allow you to decide.

We represent several carriers including Aetna, Anthem Blue Cross, Humana and more.

According to the Mayo clinic, “new cancer treatments are routinely priced at over $100,000 per year of treatment.”

5 Medicare Open Enrollment Tips You Must Know

Understand how Medicare works. Open enrollment only comes around once a year. Take advantage of this time to review all your options.
#GeorgiaMedicarePlans #GAMedigapQuotes #Turning65
How does Medicare work? Open enrollment 2018


Medicare AEP – Annual Election Period

Medicare AEP. (Almost) Everything you need to know about Medicare Annual Election Period in Georgia. A simple path to finding affordable coverage in the Medicare maze.

Medicare AEP – It’s Not for Everyone

The biggest misconception about Medicare AEP is that it applies to everyone. Not so.

If you already have a Medicare Advantage plan, or you want to SWITCH to an Advantage plan (including PDP), Medicare AEP is for you.

Everyone else sits out.

During the Medicare AEP you may make your initial purchase of an Advantage plan or make a change in your coverage. If you don’t like the Advantage plan you have now, you can switch. If you don’t like original Medicare and a Medigap plan, you can purchase an Advantage plan.

Similar rules apply to PDP (prescription drug plans, otherwise known as Medicare Part D). During AEP you may switch PDP’s or purchase a PDP for the first time.

Changing your Medigap Plan in Georgia

If you have a Medicare supplement plan you can switch to another plan with the same carrier or a new carrier at ANY TIME DURING THE YEAR. You do not have to wait until Medicare AEP because AEP does not apply to you.

Often the best time to compare Medigap rates is in December or right after the first of the year. Many Medigap carriers such as Blue Cross and AARP bump their rates for everyone in January. Unlike most carriers that offer a 12 month initial rate guarantee, BCBSGA and AARP use a common renewal date for rate increases.

Changing Medicare gap plans is relatively easy but you will be subject to medical underwriting. Most people can pass with flying colors. Bob Vineyard at Georgia Medicare Plans will pre-screen you in 3 minutes or less. If you qualify, he will show you the best Medigap rates for selected plans in your area.

Medicare Choose Wisely

Medigap or Medicare Advantage?

The biggest challenge for most Georgia seniors is deciding between original Medicare and a supplement plan or picking one of the Advantage plans.

Medicare plus Medigap is a relatively simple task since all Medigap plans are identical.

Advantage plans are as varied and confusing as repariing a transmission on a car.

Medicare Plus Medigap

Almost every doctor and hospital in Georgia accept Medicare assignment. This means if you have Medicare and Medigap you can go almost anywhere in the state or country and not have to worry about being treated.

The same is true for your Medigap plan.

If your doctor or hospital accepts Medicare assignment they will also accept your Medigap plan. Your doctor does not know who your Medicare supplement carrier is nor do they care.

The claim process is simple.

Your doctor files the claim with Medicare. In most cases in two weeks or so Medicare adjudicates the claim and sends it on to your gap carrier for payment.

If Medicare approves your claim your Medigap carrier MUST pay the claim, no questions asked. Most gap claims are paid within a week after receipt from Medicare.

When your doctor accepts Medicare assignment there are no claim forms for you to complete. Everything is handled for you by your doctor.

Medicare Advantage

While most doctors and hospitals accept Medicare assignment only about half of the doctors participate in Medicare Advantage plans.

When you purchase or switch to an Advantage plan a new set of rules apply. Your regular doctor may not participate in the Advantage plan you pick so choose wisely. This is especially true with specialists. Your primary care doctor may accept your Advantage plan but your specialist may not.

Advantage plans are confusing. Insurance carriers use gimmicks to make it seem like their plan is better than the others. A common practice is the $0 premium plan.

How sexy is that?

You get health insurance and pay nothing for it.

The devil is in the details.

Advantage plans have a lot of moving parts. At any time you may be expected to pay a deductible or copay if you plan on using the services of a doctor or lab. That may not be bad as long as you are healthy but when your health takes a turn for the worse the copay’s and deductibles add up. You can easily find yourself spending $3000 – $6000 or more out of pocket compared to less than $200 with most Medigap plans.

While you won’t find Medigap plans with $0 premiums most of the Advantage plans are in the $60 – $80 range. For about the same amount of money you could have a Medigap plan with much less out of pocket.

Medicare AEP is your reminder to search for better value.

Bob Vineyard and Georgia Medicare Plans has the lowest Medigap rates in Georgia.


Medicare AEP 2013

Medicare AEP 2013 begins on October 15, 2012 and ends December 7, 2012. Your Medicare ANOC (annual notice of change) was mailed to you a few weeks ago. The 2013 drug plans (PDP) will be available online, from your carrier and your agent beginning October 1, 2012.

General Medicare AEP Part D Datessenior-scratching-head

  • October 1 of each year – Medicare Part D Prescription Drug plan Marketing Activities can begin for the next year’s plan- At this time you will be able to once again gather information and evaluate the various Part D plan alternatives.
  • Please note, no enrollments may be accepted before October 15th for plans starting in the new year (ex: On October 1, 2012, we will begin showing plan information for the plans that will become effective January 1, 2013). The only enrollments that can be accepted before October 15th are those for people turning 65 (who want to enroll in a current year plan) or for Medicaid recipients wanting to change their current year plan.
  • October 15 to December 7 of each year – Starting for plan year 2012, the Annual Coordinated Election Period has been moved up – Here is your chance to join a Medicare Part D plan for the new plan year (however your plan will not take effect until January 1st of the new year ). If you already have a Medicare Part D plan, this is your time to look back over year and make another decision for your coverage for next year. Should you stay with your existing coverage or make a change? Here is your opportunity to decide. If you make no decision, you will remain in the same plan as you elected this year. There is no enrollment required to renew your present coverage. (If you do not enroll during this period, your next chance for coverage is January of the year after next.)

From Medicare Part D, important dates to remember

Blue Cross Georgia Medicare Changes for 2013

With Medicare AEP comes changes and BCBSGA has announced several changes that affect Georgia seniors with Medicare Advantage plans. Roughly 4600 Blue Cross policyholders will be affected by service reduction areas or non-renewal of their existing Advantage plan.

There are 5 Georgia counties where Blue Cross will no longer offer MA plans.

Those counties are Butts, Cherokee, Coweta, Douglas and Paulding.

If you live in those counties are are losing your BCBSGA Advantage plan you will have a GUARANTEED RIGHT during Medicare AEP to return to original Medicare and purchase a Medigap plan without going through medical underwriting.

Georgia Medicare Plans has the LOWEST RATES for seniors wishing to purchase a Medigap plan. Many find that Medicare supplement plan N is a great way to limit your maximum out of pocket and enjoy the flexibility of using ANY DOCTOR, any where in the United States without restriction. Compare rates here.

During Medicare AEP you have a choice to make. Do you want to change plans every year or is time for some stability in your life?