Saturday, July 26, 2014

Medicare Health Plans 2015

So what can we expect for 2015? Are Medicare health plans going to remain pretty much the same? Will there be any surprises?

It's early and companies are still in the "file and wait" mode. In other words, rates and plans have been filed with the insurance commissioners but approvals are still pending. My guesses are --

Monthly premium rates will change. Established plans with reasonable claims experience are likely to keep their rates close to the 2014 prices. Plans new to to the Medicare market often "buy" business with low rates but sometimes get stuck with "the gooey end of the lollipop." Watch for those carriers to play catch-up with higher rates and/or more streamlined benefit plans.

How long will the zero premium plans be with us? For the last three years I have said they cannot be sustained forever. Don't be surprised if your "free" Medicare health plan suddenly starts charging a monthly premium. If they do, they may sweeten the offering. Read the details.

Some plans are very "plain Jane" with their benefits package. Others are starting to understand that people appreciate the Silver Sneakers program, preventive dental, vision benefits (exam and hardware with $100 or $125/year toward glasses or contacts) and hearing aid discounts. Don't chase the bells and whistles. Look for solid customer service and a network you can live with.

HMO, PPO or Medigap
Most Medicare Advantage plans are based on the HMO or Health Maintenance Organization platform. PPO or Preferred Provider Organization plans are not as prevalent but are popular with folks that don't like being confined to a limited network. If you qualify, a Medigap policy offers the most freedom and portability. Medigap policies are a bit more expensive but can be set up with no deductibles, no office copays and no coinsurance for you to pay out of pocket.

Go Direct or Use A Professional Agent
By all means, use a professional agent that is licensed, trained and certified to help you find the Medicare health plan that 1) is accepted by your provider (s), 2) meets your needs, 3) covers your prescription medicines and 4) is within your budget. An agent is compensated by the carrier and there is no extra charge or premium to you for using an agent. Do it!

Open Enrollment
If you are currently in a Medicare Advantage plan you are "locked in" until the first of the year. Open enrollment runs from October 15th to December 7th and is the time for you to meet with your agent to see if you are in the right plan or should consider switching to something else. If you have gone direct, this is the time to connect with an agent and have him/her help you.


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