Welcome to Medicare School Daily, where we help you understand Medicare,
save money, avoid mistakes, and above all else, get the most out of your Medicare benefits. Now,
today's topic is switching advantage plans during the annual enrollment period. Many of
you have chosen to enroll in an advantage plan, you felt like that was the best way for you to
have coverage. And from time to time, you may need to switch your advantage plan. And so I’m going to
walk through the process of switching advantage plans, if it's necessary. First off, right around
the 1st of October, the present company you're with is going to send you we call the ANOC or the
annual notice of change. And that annual notice of change is their obligation to you to disclose
to you everything and anything that they're going to change from one year to the next. Now, frankly,
most companies don't change a whole lot from one year to the next. But you want to make sure that
you open up the annual notice a change. Sadly, many people assume, well, I like the plan this
year, surely I’ll like it next year. Folks don't make that assumption because they have the right
to change anything they want, and they may change something that's going to hurt you. So we open the
annual notice to change. And here's the things that we're looking for: Number one, have they
changed the premium? Many of you today are on $0 premium plans and next year will probably still
be zero. But you want to be sure you find out - Are they going to charge a premium? And if so,
what is that premium going to be to make sure you're comfortable with that. Number two,
have they changed any of the copayments? Right now you may see your doctor for $10 and
next year it may be $20, or next year may be $0. The specialist this year may be $25,
and next year may be $50. But you want to be sure to check out the copayment changes.
Also in this area, you want to look at coinsurance changes because sometimes
when a company may have a copayment this year for, let's say, an outpatient procedure of $250,
just a flat copay, and then the next year they may charge 20 percent coinsurance. So that would be
20 percent of the Medicare-approved amount, and it actually could be more than that. So you want to
be sure you're comfortable if they merely change the copayments or to coinsurance on the plan.
And then thirdly, networks are very, very important. Of course, if you're on an HMO,
it's critical because you can't go out of the networks. You have to make sure your providers
are in the network. If you have a PPO plan, you can go out of the network, but it's going
to cost you more money. So we want to make sure if there's been any network changes, that you
find those during this period of time to make sure you're very comfortable still with your network.
And then fourthly, any medication changes. In fact, this is probably the most important part
of any drug plan, whether it's embedded within the advantage plan or separate, but medication
coverage because it can be so expensive. And so you want to make sure that your medications are
still covered and you're still comfortable with the copayments with those medications. All right?
So you want to double-check that. And then lastly, perks. Perks are one of the things that draws
a lot of people to advantage plans. Typically, there's some dental benefits, some vision benefit,
maybe hearing aids, and gym membership. And so you want to make sure that all those things that
you've been enjoying with the perks of the plan are still available next year because sometimes
those perks are not as good from year to year. Sometimes they actually improve. But you do want
to make sure that you're still going to be able to go to the gym that you wanted to or, you know,
you had the eyewear a benefit. And those things just make sure you're familiar with that plan
from year to year. All right? So if we're happy with the plan, there's been nothing change that's
going to hurt us adversely, then you don't have to do a thing. When you do nothing,
the plan automatically renews. OK? Now, if it does auto-renew, I want to make sure it
auto-renewed because you wanted it to. Meaning you knew the plan was still in your best interest.
All right? And so if it's not in your best interest to stay on that plan
now, we're going to have to switch. Now let me a explain that process. We have the dates of October
15th, through December 7th. By the way, I wouldn't put it off till the last minute. I would do this
very early on, but they give us seven weeks to be able to make any kind of a switch. And there's a
couple of ways you can switch. Number one, you can go to our website here, Medicareschool.com/AEP,
annual enrollment period. And there all the information is online. You can really do this
yourself if you're comfortable doing that, and what you'll need to do is set up an account. Now,
if you already have an account set up then you just have to put in your username and password
because all your information is saved from year to year. But if you don't have one,
then set up an account. It's going to ask some basic information,
your name and your address and your date of birth and your Medicare claim number, those kinds of
things. Once you have the account set up, then what you'll do is you want to be sure that you
let us know the medications that you're taking. Again, if you already have an account, just
update the meds. So we want up to date dosage, up to date frequency of the medications. If the
doctors added a medication or dropped a medication this year, then you want to be sure your meds are
appropriate as we shop the plans for the following year, and then you want to choose your pharmacy.
Most people don't like to switch pharmacy. So if you're still happy with your pharmacy,
then you don't have to do anything other than just confirm that you would like to use that particular
pharmacy. All right? So once meds and pharmacy is updated, then what you're going to do is you're
going to push compare plans or shop plans or be a button for that. And what it's going to do is it’s
gonna look at all the plans. In your particular area, typically about county or by zip code,
and most markets around the country, there's going to be anywhere from 20 to 40 different plans
and it's going to take those plans based upon your medications. And it's going to put them
in order of the coverage of the meds and the cost of the meds, as well as any copayments
on that particular plan. And so it's going to analyze everything for you; put those in order.
Once you found a plan that you're comfortable with, whether it’s an HMO or PPO, then what you
want to do is you want to make sure that all your providers are in the network. Okay? You're going
to check your primary care doc, any specialist that you would expect to see, or maybe a hospital
that you would want to go to, but you check to make sure that network is going to be a fit.
Because if you find a plan you like and your providers are not in there, my recommendation is
find a different plan. If you're looking at those in order, just move down a notch or
two and try to find a different plan to make sure that your physicians are going to be in
the network because it's a real hassle if you can't go to the doctor that you want to. All
right? And so you want to be sure you check that. Then lastly, if you do not want to go
through this process yourself, then you can get free help from one of our Medicare school guide.
All of our guides are very well trained; they're well versed in all the markets, and very familiar
with the different plans. And so you can go to this website, Medicareschool.com/gethelp and you
can make an appointment online with one of our guides, and then they'll call you back at a time
that's convenient for you. Or you actually just call in live to this 800 number, and you'll be
able to get immediate assistance from someone that can walk you through the whole process. And if you
choose to use one of our guides, I want make sure you understand there's no cost to you whatsoever.
Insurance companies always pay us for providing these services for you, and it would be our
privilege to be walking through the whole process if indeed you need to switch your advantage plan.