The Medicare Annual Enrollment Period is also sometimes called Annual Election Period and abbreviated as AEP. This year it starts on Oct. 15 and ends on Dec. 7. During this time, Medicare beneficiaries can add, change, or drop Medicare health insurance plans and/or prescription drug coverage for the following year (effective January 1).
If you are satisfied with your current Medicare plan, you don't need to take any action. However, plan details can change annually, so you should compare your plan options to confirm that your health and prescription drug needs are covered by your plan for the next year. This is an important time for beneficiaries to reevaluate their current Medicare Advantage and Medicare Part D Prescription Drug Plan coverage and compare it with the options available in the upcoming year, because effective coverage will be locked in for a calendar year.
Agents can start to talk to clients or prospects about the upcoming year’s plan starting Oct. 1. However agents are not permitted to enroll clients until on or after Oct. 15.
In addition, agents are required to get client’s (or prospect’s) written permission in advance of discussing Medicare Insurance plans per CMS (Centers for Medicare and Medicaid Services) and keep their conversation during that original appointment narrowed down to only Medicare related topics listed on the SOA (Scope Of Appointment) form. The Scope Of Appointment form is designed to protect seniors from unscrupulous agents making Medicare appointments and then on the same appointment trying to sell prospects annuities, life insurance, or other non-Medicare related products instead. If other non-Medicare related products are to be discussed, another appointment needs to be made and discussed during that additional appointment and not on the same Medicare appointment as to comply with CMS rules.
Note: Signing the Scope Of Appointment form does NOT obligate you to enroll in a plan, affect your current enrollment, or enroll in you in Medicare plan.
To read more info from Medicare.gov click on these links:
Medicare Open Enrollment
Understanding Medicare Part C & Part D Enrollment Periods
https://www.medicare.gov/Pubs/pdf/11219-Understanding-Medicare-Part-C-D.pdf
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Many people ask me what are some of the things I need to look for when comparing Medicare insurance plans against each other?
My suggestion is to check at least the following items:
- Star Ratings for Medicare Advantage Plans and Prescription Drug Plans.
(Provided each year by Medicare. Keep in mind that they can change from year to year. The star ratings can be found at Medicare.gov. If you cannot go online, each Medicare insurance plan enrollment guide booklet should also include the updated upcoming year’s Medicare star ratings for that specific plan.) - Review the "Benefits at a Glance” or more comprehensive “Summary Of Benefits.”
In my opinion, listed below are some of the important (but not limited to) items you should focus on and that you should consider before making a final decision on which plan you choose:- What type of Medicare insurance plan is it? Medicare Advantage HMO, Medicare Advantage PPO, or a Medicare Supplement with perhaps an additional stand alone drug plan. (PDP)
- Annual Out-Of-Pocket Maximum (That is the most you will pay in a year for Medical expenses with a Medicare Advantage plan. Note: This Annual Out-Of-Pocket Maximum amount does NOT include a maximum amount for prescription drugs, even if prescription drugs happen to be included in your plan.)
- Copays for primary care physicians and also copay amounts for specialists.
- Inpatient hospital care per day cost and how many days you have to pay.
- Outpatient surgery cost Find out if the outpatient surgery amount you are responsible for is just a flat amount (copay) or a percentage of the total amount (coinsurance). The amount you are responsible can be different with each plan so be sure to check that out.
- Emergency Care costs
- Diagnostic radiology services and diagnostic tests/procedures costs
- Ambulance
- Prescription Drugs - Find out if your specific drugs are included in the formulary (complete drug list) of the plan you choose. Then find out the Tier level and/or cost of each of your drugs. Also find out which Pharmacies are in the network and also which are considered preferred Pharmacies for that plan - allowing you to get the least expensive prices.
- If the Medicare insurance plan you choose has a network. Find out in advance if each of your specific doctors, hospitals, and other providers are in network for that specific Medicare insurance plan.
- If a fitness program is important to you, find out if a basic gym membership is included in your Medicare insurance plan at no additional cost.
- Find out in advance if you can travel and still be covered for non-emergency visits to the doctor, etc. with that specific plan. (Note: Almost all the Medicare insurance plans do cover you if it is a true emergency!)
- Plus there are many other items to compare between plans, so determine what is important to your specific needs before making a decision! Some other options in some plans may or may not include dental and/or vision.
- What type of Medicare insurance plan is it? Medicare Advantage HMO, Medicare Advantage PPO, or a Medicare Supplement with perhaps an additional stand alone drug plan. (PDP)
I am an independent insurance agent, certified to handle multiple Medicare insurance companies, allowing me to help you find the Medicare insurance you feel fits your needs. I pride myself in providing excellent customer service to my clients. I will be attentive to your needs and strive to meet or even exceed your expectations for your Medicare insurance needs.
By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.
If you are confused and/or want more information about which Medicare insurance plan to enroll in, either as a new plan or even if you are just switching to a different Medicare Insurance plan, please call me at 941-404-5334 to set up an appointment to discuss further. If relatively local, I’ll come right at your home, office, or other location.
By calling this number, I understand I will be directed to a licensed insurance sales agent.