04/12/2024
2024 Spring Update
Hello everyone,
I hope you're doing well. In the past few months, we have received several questions regarding Medicare Advantage plans, prescription drug coverage, and Medicare Supplement plans. Here are the top three questions and their answers:
Q: My doctor doesn't accept my Medicare Advantage plan anymore. Can I switch to another company?
A: Unfortunately, losing a doctor from your Advantage Plan won't qualify you for a special enrollment period. Until the Annual Enrollment Period at the end of the year, the only way to switch Medicare Advantage plans is to enroll in a 5 Star plan, which is open for enrollment year-round. However, you can change plans once a quarter if you qualify for Medicaid.
Q: The cost of my Ozempic (insert any brand name drug here) has increased dramatically. What happened?
A: You might have hit the coverage gap (donut hole). When you fill a prescription for the first time, you usually pay a copay, let's say, $50. But remember that your portion and your insurance provider's portion of the prescription cost count toward the coverage gap. So, if you pay $50, and your insurance provider pays $950, that's $1000 going toward the coverage gap.
This year, the coverage gap starts at $5,080. Once you hit the coverage gap, you're responsible for 25% of the prescription cost. In this case, 25% of $1000 is $250. You'll have to pay $250 after taking the $1000 drug for approximately five months.
Q: My Medicare Supplement plan's price has increased. Is there another company that offers a less expensive plan?
A: All Medicare Supplement plans receive rate increases, although they occur at different times of the year. A different company may have a lower rate, but it might catch up in a few months.
Other factors that make it challenging to find a lower rate are:
1. Your rate is determined by your age when you initially enrolled, and as time goes by, you stay at that age when your company determines your monthly rate. If you move to another company, you'll be charged at your attained age, and you might not save any money.
2. Medicare Supplements require medical underwriting once you pass the first six months of enrolling in Medicare Part B. If you have a chronic condition, another company might not accept you.
I've found that the major Medicare Supplement companies that I recommend remain competitive with each other; most likely, a better deal will not be found somewhere else.
Thank you once again for your business and your referrals!
I am here to help with any questions or concerns you might have.
Enjoy the cool weather. Health and Happiness.
