Be Sure You Know the Details of Your Medicare Plan!

Individuals on Medicare should pay close attention to open enrollment, especially regarding their prescription medication coverage and options for Medicare Advantage plans. Open enrollment ends on December 7, 2019 and after that changes can be made ONLY for specific and extenuating circumstances.

For Medicare Prescription Drug Plan, also known as “Part D,” most beneficiaries (89%) 65 years old or older, take at least one prescription medication. Being aware of your coverage is important and should be reviewed each year. “Part D” Plans might add or drop drugs from coverage as well as potentially change cost-sharing components including deductibles and co-pays.

Another little known fact concerns Medicare Advantage plans. If a person chooses a Medicare Advantage (MA) plan either as part of initial enrollment OR switches off of traditional Medicare to go on an MA plan, they will lose status with the supplemental plans and have to go through underwriting should they want to return to a traditional Medicare benefit with part A, Part B, a supplement and Part D.

This fact can be a big deal for Medicare aged folks trying to contain costs especially if they are experiencing multiple comorbidities and requiring frequent therapy or hospital visit. Currently, a traditional Medicare plan set (A, B, D and supplement) costs in premiums about $3900 annually. Many of the Advantage plans have deductibles and OOPs of over $6000 per year which doesn’t even account for premiums.

Obviously, each option has its pros and cons, but folks are not always being told that going back to a traditional Medicare option is not a clear cut process when leaving a Medicare Advantage plan. Make sure you discuss your options with your insurance broker and get ALL the facts up front.

Dave Grady
President / Big Sky IV Care