post

Make the Most of Medicare’s Annual Enrollment Period

You’ve probably seen those TV ads urging Medicare recipients to call about Medicare Advantage plans or Medicare Part C, and talking about the Annual Enrollment Period (AEP). Some of their promises sound too good to be true. Should you consider a Medicare Advantage plan? Medicare Advantage plans can be a good option for many—in fact, according to AARP, in 2023 more than half of Medicare beneficiaries enrolled in a Medicare Advantage plan.

The AEP, which runs from Oct. 15 through Dec. 7, is the perfect time to examine your current Medicare coverage, note any changes taking place in the upcoming year, and see what other options are available to you. Changes you make now take effect Jan. 1, 2024.

But before you call that 800 number, why not call someone you know and trust—like local independent agency L & M Insurance Group? Read on for more information about Medicare Advantage plans and more!

Is a Medicare Advantage plan right for you?

There are two ways you can receive your Medicare benefits: through original Medicare or through Medicare Advantage. Original Medicare consists of Parts A (hospital coverage) and B (medical coverage). Many people also enroll in a standalone Part D prescription drug coverage policy.

Medicare Advantage plans consist of parts A and B and often Part D. These plans are offered by private insurance companies approved by Medicare. Medicare Advantage plans are similar to the managed care plans you may already be familiar with through your employer. They’re often HMOs or PPOs: you will need to see providers in the plan’s network or pay a much higher copay or risk not being covered at all. Most of these are regional networks, so if you’re a snowbird who lives up north during the summer, you probably won’t have in-network options for your non-emergency healthcare. You will likely need referrals for specialized care and preapproval before certain treatments are covered. Some say that denials of coverage are more frequent than with original Medicare. However, through the careful management of care, a Medicare Advantage plan can often cost you less out-of-pocket and sometimes include coverage for dental, vision, and hearing, which original Medicare does not.

The AEP is one of the only times you have to change the way you receive your Medicare benefits. During this period, you have several options:

Choosing between Medicare and Medicare Advantage

  • Change from original Medicare to a Medicare Advantage plan (also known as Medicare Part C)
  • Change Medicare Advantage plans
  • Switch from a Medicare Advantage plan to original Medicare

If you’re happy with your current choice, you can stay with it as long as it is still being offered—just be sure to check if there are any changes that affect your coverage to the plan you’re currently enrolled in. You should have received an Annual Notice of Change listing any upcoming changes. Medicare Advantage plans and Medicare drug plans may change what they cover, their costs, and their provider networks from year to year.

Health care costs can eat up your retirement savings, so carefully consider your health and financial situation. Someone with a health history of chronic disease that requires expensive prescriptions will likely need a different plan than someone who sees his or her doctor once a year for a physical.

Questions to consider when choosing a plan during Annual Open Enrollment

  • Have you received a new diagnosis or started taking a new medication?
  • Did you change doctors?
  • Can you afford the costs (copays, deductibles, etc.) that come with your current coverage?
  • Does your prospective plan include your doctor in network?

Find out more from L & M Insurance Group

There is a lot to sort through during the AEP, but it’s worth taking the time to review your health care coverage to see if it still meets your needs. If you’d like help understanding your Medicare options, why not have a trusted insurance professional help you? In addition to providing Medicare Advantage plans through companies like Aetna and UnitedHealthcare, if you’re staying with original Medicare, L & M Insurance Group can also help you with a supplemental (“Medigap”) policy or a Medicare prescription drug plan. Call us at (813) 672-4100, or click here to contact us online.  

For more information, see the 2024 Medicare & You Handbook.

post

Choosing Medicare Options That Are Right for You

Nearly 4.8 million Floridians are enrolled in Medicare, the U.S. health care program for people over 65. If you’re one of them, you probably know that during the Annual Enrollment Period, from now until December 7, you have the opportunity to change how you receive your Medicare benefits. Changes you make now will take effect beginning Jan. 1, 2023.

Original Medicare or Medicare Advantage

You can receive Medicare benefits in one of two main ways: Original Medicare, which is a fee-for-service health plan with two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Once you pay a deductible, Medicare pays its share of the Medicare-approved amount, and you pay your share. If you need drug coverage, you can add a separate Medicare drug plan (Part D).

The second option for receiving Medicare benefits is Medicare Advantage, also known as Medicare Part C. Medicare Advantage is provided by private insurance companies that contract with Medicare. Plans include part A, Part B and usually Part D. They may also offer extra benefits that Original Medicare doesn’t offer, such as vision or dental. The number of Medicare Advantage plan choices continues to increase—according to the Tampa Bay Times, “Floridians enrolled in Medicare will be able to choose from 627 Medicare Advantage plans compared to 583 plans in 2022.”

Considering your options

So how do you choose?

Coverage is very similar. Both options cover most medically necessary services and supplies related to care in the hospital, your doctor’s office, and other healthcare facilities. Main differences include things like doctor and hospital choice (with Medicare Advantage, you need to stay in the plan’s network for non-emergency care), whether or not you need a referral to see a specialist, and as mentioned above, whether or not some routine exams—vision, dental, hearing—are covered. Medicare Advantage plans are increasing in popularity among Medicare-eligible seniors, largely because of the added benefits available as well as the cap on out-of-pocket costs, something Original Medicare doesn’t have.

As you consider your options, think about what type of healthcare needs you’ll have over the coming year. Of course, unexpected things happen, but you may already know you’ll need to see a specific doctor, or you’ll need certain prescription drugs over the course of the year. Once you have this figured out, you can compare plans to see which one is right for you. It pays to spend some time comparing the total you’ll pay for medical care, including premiums, co-pays, and deductibles for each option.

For more in-depth information on how Medicare Advantage and Original Medicare plans compare with each other, click here.

How L & M Insurance Group can help

Sound confusing? If you’re interested in finding out more about Medicare Advantage plans, L & M Insurance Group can help. In addition, we can also help if you want to stay with Original Medicare, but you want a supplemental policy (“Medigap”) to help cover your deductibles and coinsurance costs. A supplemental policy may be cheaper for you than covering all the out-of-pocket costs on your own, especially in the event of a catastrophic illness. We represent companies that offer Medicare Advantage, Medigap, and Medicare Prescription Drug plans, including UnitedHealthcare and Aetna. We’ll be happy to help you decide if one of these plans makes sense for you. Please call us at 813-672-4100, or click here to contact us online.

For additional information on Medicare benefits and plans, please see  https://www.medicare.gov/

post

How We Can Help With Medicare Coverage

Be Ready For Medicare Annual Election Period

Once you become eligible for Medicare at age 65, you have some decisions to make. Will original Medicare Part A and Part B be sufficient for your health insurance needs? What about Medicare Advantage (also known as “Medicare Part C”), prescription drug coverage (“Part D”), or Medicare Supplement (Medigap) insurance?

Now is the time to evaluation your Medicare coverage to see if it meets your needs, since we’re about to enter an annual election period (AEP). Between Oct. 15 and Dec. 7, eligible people may sign up for Medicare Advantage or make other changes to their Medicare coverage.  Once this period is past, you’re more limited in the changes you can make in your health insurance plans. 

Medicare Advantage and Medicare Supplement Plans

L & M Insurance Group offers both Medicare Advantage and Medicare Supplement plans. We represent Aetna, UnitedHealthcare, and other companies.

Medicare Advantage, or Medicare Part C, is a different way to receive your Medicare benefits. Under original Medicare, the government pays for your benefits when you get them. Medicare Advantage plans are offered by private insurance companies approved by Medicare. The government pays these companies to cover your Medicare benefits. There are different types of Medicare Advantage plans, including those operating as Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs). Some Medicare Advantage plans offer benefits original Medicare doesn’t, such as vision or dental. Plan benefits can change from year to year.

As with any type of insurance, there are advantages and disadvantages to choosing a Medicare Advantage plan over original Medicare. Please call our office at 813-672-4100 to speak to an agent who will help you decide if a Medicare Advantage plan is right for you, and which plan offers the best coverage for the best price.

Medicare Supplement, or Medigap, insurance helps pay certain out-of-pocket costs not covered by your original Medicare benefits, such as co-payments, coinsurance, or deductibles. Medigap policies are standardized and must offer the same basic benefits, but some policies offer more benefits than others. These policies can only be purchased by people who have original Medicare.

Helping You find the Right Medicare Coverage

When deciding on health insurance for your retirement, you’ll want to think about what your healthcare needs will likely be, and compare premiums, deductibles, and co-payment requirements in order to decide which plan offers the best coverage at the lowest price.  L & M Insurance Group can help you find the best Medicare Advantage or Medicare Supplement plan to suit your needs. Just give us a call at 813-672-4100. For more information on Medicare benefits and plans, please see https://www.medicare.gov/