TEMECULA – If those on Medicare, it is important to read the annual notification of change, health plan or Part D plan each year to see if there are any significant changes. Seniors cannot assume that things will remain the same.
Each year the health plans change their benefits in order to attract Medicare beneficiaries to their plan. Sometimes they add benefits in one area by decreasing coverage in another. It is important to decide which benefits matter most personally and start there. Not all plans are contracted with all Medical groups. Some offer gym membership while others offer over-the-counter catalogs to help with non-Medicare covered items such as vitamins or cold medicines. Drug formularies differ from company to company. For 2020, many Medicare Advantage and Part D plans are covering generic drugs with no copay. This year some plans will cover certain brand name drugs through the “donut hole,” if subscribers use their mail order program. There are a lot of options out there. Make sure to see them all.
For 2020, those who end up in the “donut hole,” or coverage gap, will be glad to know that they’ll pay no more than 25% of the cost for brand name drugs. In addition, 95% of the price, which is a combination of what the patient pays or 25% and the manufacturer discount or 70%, will be applied to their total out-of-pocket cost which will get patients out of the coverage gap sooner.
There are a lot of things to evaluate when considering changing health care plans. It is important to seek out a qualified Medicare broker who knows the ins and outs and can support seniors in making a decision. A Medicare broker comes at no cost to seniors as they are compensated by the health plan that wins a patient’s business through their enrollment.
For more information, call Cecelia Brown at (760) 445-2269. Cecelia Brown is a licensed agent with over 35 years’ experience working with Medicare products.
Submitted by Cecelia Brown.