EDITOR’S NOTE: Our Medicare Surveys “take the pulse” of our audience – assessing our readers’ experiences with Medicare and their attitudes toward the program. The questions and the results are not intended to be scientific.
Are Medicare enrollees thinking about rethinking their current coverage? It appears so, based on the results of our third Medicare Survey – a regular poll of this site’s readers.
In the current survey – which concluded not coincidentally as Medicare open enrollment starts – more than 70 percent of respondents indicated they’re ready to compare their existing coverage with 2021 Medicare Advantage and Part D prescription drug plans.
We asked, “Will you ‘shop around’ during Medicare’s open enrollment (Oct. 15 – Dec. 7)?” The responses, based on 181 surveys submitted by our readers:
- 49.2% Yes. I want to compare my coverage to 2021 plans.
- 25.4% No. I’m satisfied with my current Medicare coverage.
- 22.1% Yes. I’m ready to change my Medicare coverage.
- 3.3% No. I don’t believe I’m allowed to make changes at this time.
Primed for change?
What’s going on here? Is 2021 coverage expected to be drastically improved or less expensive? The real answer is that enrollees are simply being driven by advertising. Right now – and until December 7 – Americans eligible to make changes in their coverage during the Annual Election Period (often referred to as Medicare open enrollment) are being bombarded by marketing. About half of the calls I get are driven by ads on TV or radio or by direct mail.
Is that a bad thing? I personally think it’s great news that consumers are getting reminders about a once-a-year opportunity to:
- change coverage so they can visit a doctor or hospital they want
- change plans because their existing coverage doesn’t cover a prescription drug they now need
- change plans because they’ve had an issue with their carrier’s service
- find a 2021 plan with – yes, sometimes – a lower premium.
Will everyone respond to the marketing blitz? In my experience – and based on the 25.4 percent of responses in this survey – many enrollees feel perfectly happy with the coverage they have.
But my question for my clients would be “If you can improve your coverage, why wouldn’t you at least explore your options?”
(Note to the 3.3 percent of this survey’s respondents who don’t believe they’re allowed to make a change: all Medicare enrollees can review and change Medicare Advantage or Part D plans during Medicare open enrollment. But the open enrollment window does not apply to Medigap plans, which might cause some of the confusion)
I’d follow up on my question with some advice about “shopping around.”
First, I’d definitely recommend checking your Advantage or Part D plan for possible doctor/provider changes and drug list and pharmacy changes. (And using the information sent by your current 2020 plan with the upcoming 2021 information is not always the best way to go about selecting the best plan for you in 2021.)
If you are on a limited network (HMO or PPO) Advantage Plan, contact your current doctors to confirm their network options for the upcoming year. I don’t recommend using the online directories because even though providers and insurance companies do their very best to keep these directories updated, the reality is that it’s always best to confirm directly with the doctors / providers.
PRO TIP: When you call a provider’s office, don’t ask, “What Advantage plans are you accepting for next year?” Instead, ask, “What Advantage plans are you accepting in 2021 for both HMO and PPO?” It’s no fun when a doctor’s office tells you Carrier X, and you enroll in Carrier X HMO – only to find out later that your doctor only accepts the Carrier X PPO.
Second, if you have an Advantage Plan with Part D coverage or a separate Part D plan, it’s very important to check your drug list – or formulary – at Medicare.gov. The Medicare Plan Finder will default to the lowest-cost plan based on the premium (x12 months) plus the deductible and amount you pay at the pharmacy. At that point, you look at the plan details to determine the costs at the individual pharmacies.
After you’ve selected the prescription drugs you need with the plan finder, pick four pharmacies: your favorite pharmacy, your grocery store, and then both Walgreens and CVS. The fifth pharmacy should be mail order. You may not expect to like mail order, but it’s a lot more likable if it saves you a significant amount of money.
PRO TIP: If you’re taking an insulin on the CMS Innovations List and the system prompts you to use the insulin savings model, by all means, look at the options. However, you also need to look at the options without the savings model.
Third: as always, if something sounds too good to be true, it probably is. So talk to somebody and ask for a full explanation of any enticing offer. Preferably, seek an agent who represents most of the companies in your area – and not an agent who represents just a single carrier.
The final – and most important – goal of the Medicare Annual Election Period is peace of mind – just confirming that your current plan is going to meet your needs in 2021 and that you know the estimated cost. You can do this by creating an account at Medicare.gov using your Medicare ID number on the red, white and blue card and go from there.
Jenny Chumbley Hogue brings over 30 years of health industry experience to her role as a contributor for medicareresources.org. The owner of her own health insurance agency – KG Health Insurance – Jennifer specializes in Medicare, small-group insurance and the individual health insurance market. She takes great pride in not only understanding the details and laws regarding Medicare and individual-market health Insurance, but more importantly, being able to explain to regulations to consumers in a way that is easy to understand.