THE MEDICARE ANNUAL ENROLLMENT PERIOD (AEP) IS RIGHT AROUND THE CORNER

THE MEDICARE ANNUAL ENROLLMENT PERIOD

It is almostt time again for the Annual Enrollment Period to begin, we are just five weeks away, so I thought it was time not just for a reminder, but to speak about why this years AEP (Annual Enrollment Period) will perhaps be one of teh busies AEP’s in teh last 10 years.

One of your homework assigmnments before every AEP should be to review the Annual Notice Of Change Letter that you receive in September. Everyone with a Medicare Advantage Plan or a Medicare Part D Prescription Drug Plan will receive your ANOC (Annual Notice Of Change Letter). This letter is actaully more like a packet or a dossier. And, it includes important information about your current plan. Information like will your plan still be available for the 2025 Plan Year, Have the premiums gone up, or; will your plan go away, leaving you with the need to find a new plan for 2025. They will also include a side by side comparison of your plan in 2024 and your plan with any changes for 2025, so you can easilty see if the plan still makes sense for you.

WHAT YOU CAN DO DURING THE MEDICARE ANNUAL ENROLLMENT PERIOD THIS FALL

The Fall Open Enrollment Period Starts on October the 15th and ends on December teh 7th, here is what you can do during this important time:

If you are a Medicare Advantage Member, you can choose to stay with your current Medicare Advantage Plan, as long as yoour plan is still available. If that is what you decide to do, then you do not need to do anything else. Your plan will automatically renew on January 1st.

If you have a Medicare Part D Prescription Drug Plan, you really need to investigate your options for 2025. Why? Well, because there are some mayor changes to ALL Part D Plans in 2025, thanks to the Biden Administration’s Inflation Reduction Act (IRA), which obviously has done nothing to curb inflation.

LET’S LOOK AT THE CHANGES BROUGHT ABOUT BY THE IRA:

• For starters, the maximum out of pocket that anyone will have to spend on Prescription Drugs in 2025 will be $2,000.
• The Catastrophic Phase of Coverage thay everyone referred to as the Donut Hole is gone in 2025.
• Medicare Part D Premiums are increasing overall by 6%.
• The Medicare Part D Plan Deductibles are increasing to $595.00.
• You will have options to delay the full payment of your initial prescriptions. You can make payments without paying the full amount at the pharmacy. This is just meant to be a helping hand, it is not a loan, your prescriptions are not free, and you must make your installment payments, or risk losing your coverage.
• Many Part D Plans have been dropped for the coming year. In Arizona alone, Mutual of Omaha and BCBS will no longer offer Part D Drug Plans. And, other companies have cut back on the variety of plans they will be offering.

YOUR MAILBOX WILL BE FILLED WITH AN ENORMOUS AMOUNT OF JUNK MAIL, MOST OF THIS IS 99% JUNK MAI

We have always recommended that the only mail you should keep during teh AEP is:

• Anything form CMS (Centers For Medicare and Medicad Services).
• Anything from Social Security.
• Anything form your current Insurance Provider, this includes your Medicare Advantage Plan, Your Prescription Drug Plan and Your Medicare Supplement Plan.

Everything else is just junk (flyers, brochures and propaganda, from other insurance companies and agents of other Insurance Companies).

YOUR EYES AND EARS WILL BE BOMBARDED WITH MEDICARE TELEVISION ADS AND RADIO ADS

These Medicare Insurance Companies (Mostly Medicare Advantage Companies) use the money they receive from the Government to pay for these ads. They are slick, they are intentionally written and produced to coonfuse the viewer, by imploring them to call a Toll-Free Number so that you can “make sure you are getting all of the benefits you are entitled to”. Pardon me, but these vultures are simply preying on the fears and confusion of Seniors. However, they do not tell the whole story.

Most people who call one of those numbers end up enrolling in a Medicare Plan, from another company, and usually, it is a plan that has less benefits and higher co-pays than your current Medicare Advantage (Medicare Part C Plan). And, they do not understand their new plan stinks until they go to the doctor in March or April, and they are stuck with that plan for the rest of the year.

Remember this about Medicare Advantage plans. Not every plan and not all benefits are available in every market. There are more than 4,400 Medicare Advantage plans across the country. So they may quote a benefit, you have not heard of before, and that is usually because it is not available where you live.

NOTE: If you have a friend, relative or loved one that has Medicare, please assist them infinding an experienced, Independent Medicare Broker in tehir area. By doing this, they will always have someone to call whenever they have a question. Someone who does not charge a penny for their services, and someone who is an expert when it comes to Medicare, Medicare Insurance plans, and someone who understand all of the options available.

THE MEDICARE ANNUAL ENROLLMENT PERIOD, AND THE FALL ENROLLMENT PERIOD ARE THE SAME THING

Also called the Annual Election Period, the Medicare Fall OEP came about with the introduction of Medicare Part D in 2006. It is an 8-week period every fall during which Medicare beneficiaries can enroll in, change, or disenroll from their Medicare Advantage and/or Part D drug plans.

Here’s why the period exists: Part D plans and Medicare Advantage plans get to re-file their benefits with Medicare each year.

This means the benefits and premiums on your plan can change or go up. So Medicare lets you have an election period each year to change your plan if you don’t like the changes to your existing coverage. Basically, your Medicare Prescription Drug benefits change every year, so you get an election period to change your plan if you don’t like those benefit changes.

Now, the good news is that you do NOT have to change your plan if you like your plan. In fact, statistics show that the majority of beneficiaries do NOT make changes to their plan each year. However, you absolutely should be reviewing the upcoming plan changes every September.

WHAT CAN YOU DO OR CHANGE DURING THE AEP?

Your choices for plan changes during the Medicare OEP?

• Do nothing, and your current Medicare coverage will automatically renew in 2025
• Enroll in, leave, or change your Medicare Part D drug plan
• Switch from Traditional Medicare to a Medicare Advantage plan
• Switch from a Medicare Advantage plan back to Traditional Medicare
• Change from one Medicare Advantage Plan to another

Please remember that that Medicare Part D drug plans have no health questions. You can change to any other plan as long as you have either Medicare A and/or B and you live in the plan’s service area.

Medicare Advantage plans have only one health question about End Stage Renal Disease, so it’s also fairly easy to enroll in or change your Medicare Advantage plan as long as you don’t suffer from this particular health condition.

HERE ARE THE BEST AND MOST COMMON REASONS WHY PEOPLE CHANGE THEIR MEDICARE ADVANTAGE OR TEHIR PRESCRIPTION DRUG PLANS EACH YEAR

• Your plan is dropping one of your important medications next year. Your Annual Notice of Change letter will specifically list any changes to its drug formulary for next year. The plan must disclose if they are dropping any medications. They must also tell you if a medication is moving to a more expensive tier for next year. If you take a brand-name medication now that won’t be covered the next year, you may want to change during the OEP to another drug plan that will.
• Your Medicare Advantage plan is dropping your doctor from its network. Unlike Medigap plans, Medicare Advantage plans have a network of doctors. If one of your doctors is leaving the plan’s network, you can use the Medicare OEP to switch to another plan that your doctor still participates in.
• Your plan has a drastic increase in premium. Please note that the keyword here is “drastic.” Inflation happens to medical insurance plans just like it does to auto insurance plans. If your auto insurance goes up $3/month next year, would you go to the hassle of changing it? Probably not. Likewise, if the only thing changing on your drug plan is a small increase in premium, you don’t have to switch. But if your drug plan goes up $20/month, you might look to see if any other plan is cost-effective.

MEDICARE CHANGES FOR THE 2025 PLAN YEAR

In 2018, the Bipartisan Budget Act brought about changes to Medicare Advantage plans. Whereas Original Medicare does not cover supplemental home health benefits, Medicare Advantage plans are now able to include them.

So if you are looking at Medicare Advantage plans, you may notice that many of them will now include some supplement home health benefits. This may include personal support services in your own home, transportation to and from medical appointments, adult day care services, telehealth medical appointments, over-the-counter allowances, and meal delivery.

WHAT ABOUT YOUR MEDIGAP OR MEDICARE SUPPLEMENT PLAN?

YOUR MEDICARE SUPPLEMENT OR MEDIGAP PLAN

Your Medigap plan has federally standardized benefits that do not change from year to year as Part D plans do.

If you have a Medigap Plan F, Plan G, or Plan N (or any other Medigap plan), rest assured that nothing will change with the benefits. Your plan next year will continue to cover all the same benefits that it covered this year. Rates May Change, Benefits Do Not

Medigap plans normally have rate increases annually, but the rate increase occurs on your policy anniversary date. If you originally bought your policy on January 1st of a past year, then your policy renewal does occur each year on January 1.

That means you will receive your notice of increase from your carrier in December. It just happens to occur along with the OEP, but it is not related to the Medicare Fall Open Enrollment Period.

Think of this like your automobile , renters or homeowners insurance:

If you originally bought your homeowners insurance on June 1st, 2014, then every year on June 1st, you will get a rate increase. The same thing happens with Medicare supplement insurance.

If your Medigap plan happens to renew each year in January because you originally bought it with a January 1st effective date, that is coincidental. The plan’s benefits are NOT changing, only the premium changes from year to year on Medigap plans.

SHOULD YOU SHOP YOUR MEDICARE SUPPLEMENT PLAN DURING THE AEP?

• Now that you know your Medigap benefits will not change, it’s completely up to you whether you want to try to shop it in the fall. Some people do shop it since they are already comparing Part D so that they can knock out both items on their to-do list for that year.
• We often find people who have been on the same Medigap plan for years and have been fearful to change because the plan pays so well. Rest assured, Medigap plans are standardized. Anyone with aMedicare Supplement/Medigap plan should review rates at least every other year, just to ensure they are not leaving money on the table.
• The Medicare OEP Does Not Prevent Underwriting on New Medigap Policies
• Many people mistakenly believe that you can change your Medigap plan during the OEP without health questions.
• That is not the case because, as we said above, the OEP doesn’t pertain to Medigap. In most states, you will have to answer some health questions on that new application. The insurance company can decide whether to accept or reject you.
• Medigap plans require you to pass medical underwriting unless you have a special circumstance that qualifies you for a guaranteed issue window. For example, if you move out of state mid-year, you’ll be given a Special Election Period.
• You can use this short period to change to a plan offered in your new service area. If you don’t have a special election period, you’ll need to answer health questions to get approved for a new Medigap plan.

IS THE MONTHLY MEDICARE PART B PREMIUM GOING UP IN 2025?

Every year the federal government can adjust your Medicare Part B premium. Part B premiums are tied to the Cost of Living Adjustment in your Social Security benefits. Back in 1965, new enrollees paid $3/month for Medicare Part B.  In 2024, new enrollees pay at least $174.70/month, but this will likely change for 2025. Some people pay more based on their household gross income.

Generally, Social Security issues a COLA inflation adjustment that increases your Social Security monthly income benefits, and then the Part B premium usually also goes up. The most common projection I have seen is taht SOcial Security Benefits are probably going to increase by around 2.6% in 2025. So, I am expecting a modest increase in the Part B Monthly Premiums.

Normally, we do not find out what the new Premiums for Part A and Part B will be until October.

WRAPPING THINGS UP

I hope this article about the Medicare anual Enrollment Period was felpful, informative and interwesting. We would love to hear your comments, so please feel free to email us at mike@bradenmedicare.com anytime, and please ask to signup for our monthly newsletter.