Three Lessons Learned During AEP

Karen Blake

Blake Insurance and Financial Group

The Annual Enrollment Period (AEP) is a period of time during which Medicare beneficiaries can make changes to their Medicare coverage. The AEP runs from October 15th to December 7^th every year. During this time, people with Medicare can make changes to their health coverage which will go into effect on January 1^st of the following year. Changes that can be made during AEP include switching from traditional Medicare to a Medicare Advantage plan (or vice versa), switching between Medicare Advantage plans, and electing or switching between Part D prescription drug plans. As a licensed Medicare insurance agent, here are three important things which I believe are important to know during AEP:

Review and Compare

Anyone who has a Medicare Advantage plan should review it every year during AEP because plan premiums and coverages can change each year. Changes in the rules and regulations of your plan can have an impact on your care and costs.  It’s a good idea to compare other plans with your current plan because the costs, provider networks and services offered differ between plans. Also, new, more affordable Medicare plans may become available in your area. Reviewing all the plans available during open enrollment gives you a better opportunity of finding the best option for your needs.

Know and Understand Your Options

If you are currently on original Medicare (with or without a medigap policy) and considering switching to an MA or MAPD plan, know how they differ and consider the pros and cons. Medicare Advantage (MA) plans are a type of health insurance plan offered by private companies that have been approved by Medicare. They are an alternative to Original Medicare and include Medicare Part A (hospital coverage), Medicare Part B (medical insurance) and often Medicare Part D (drug coverage). MA/MAPD plans are structured so that you don’t need to add a Medigap plan. Most MA and MAPD plans offer additional benefits that aren’t covered under Original Medicare such as dental, hearing, and vision care, and sometimes wellness programs. Some pros and cons to consider are as follows. Please note that this is not an exhaustive list of pros and cons, and you should carefully consider your own needs and preferences when choosing a plan.

Pros:

• Lower out-of-pocket costs than Original Medicare
• Additional benefits not covered by Original Medicare, such as fitness classes or some vision, hearing and dental care
• Prescription drug coverage is often included
• Cannot be declined for health reasons

Cons:

• You may be required to use doctors in the plan’s network
• You may need a referral to see a specialist
• You may have to pay more if you go out of network   

Work With a Local Medicare Agent

Understand the value of working with a local Medicare insurance agent. Medicare agents and brokers are very knowledgeable about the Medicare plans in their area. Every year they have to complete training and pass a test on the rules and regulations for Medicare for the upcoming year, and also for health and prescription drug plans. Local Medicare agents and brokers can meet with you in person to help you review health plans in your area, enroll in a plan, and provide objective recommendations based on your needs and preferences. They are also able to explain the benefits, rules, and exceptions of Medicare plans, which can be quite complex to navigate on your own. A Medicare insurance agent who lives and works in your community can become a trusted resource for many years to come.

Conclusion

With the complexities involved with Medicare, keeping these three lessons in mind will help your enrollment period go smoothly: review and compare plans, know and understand options, and work with a local licensed Medicare insurance agent. For more information, please reach out to The Blake Group.

About the Author: Karen Blake is an independent, licensed insurance producer and Medicare advisor in Lexington, SC. She is the co-founder of Blake Insurance and Financial Group. If you have questions about your Medicare options you can reach her at [email protected].