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Medicare November 2019

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Volume 3, Number 2

IN THIS ISSUE...

2020 STAR RATINGS RELEASED

PROBLEMS WITH MEDICARE.GOV PLAN FINDER

SENIORS SPEND THOUSANDS RETROFITTING HOMES TO AGE IN PLACE

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News & Updates For Medicare Beneficiaries

Medicare Annual Enrollment continues through December 7 for a January 1, 2020 effective date. 2020 star ratings have been released. There are errors in the medicare.gov plan finder. We encourage you to call us at 877-734-3884 or 561-734-3884 for help in enrolling in a plan or in checking out the coverage for your medications.

2020 STAR RATINGS RELEASED

The Centers for Medicare & Medicaid Services (CMS) published its star ratings for 2020 Medicare Advantage and prescription drug plans on October 11.

Enrollment kits for 2020 plans have contained the 2019 star ratings. Newly published kits will contain the 2020 ratings, and as of late October agents are required to replace 2019 rating sheets contained in previously published enrollment kits with the new ratings before they distribute these kits to beneficiaries.

Star ratings, which are required by the Affordable Care Act, utilize a five-star scale, and are based on clinical factors such as chronic disease management as well as member experience and customer service measures. Specific measures included in star ratings change from year to year. 2020 star ratings are based on measures made in 2018.

Star ratings are one way to compare Medicare Advantage and Part D drug plans (there is no star rating system for Medicare Supplement plans) and affect reimbursement rates Part C and D carriers receive from Medicare. Carriers with higher reimbursement rates receive larger reimbursements from CMS, and plans who achieve an overall star rating of 5 are permitted to enroll beneficiaries on a year-round basis (and not just only when a beneficiary first becomes eligible for Medicare or during Annual Enrollment which runs from October 15 to December 7).

Most people with Medicare will have access to Medicare Advantage (MA) and Part D plans with four or more stars in 2020, and about 81% of MA enrollees with prescription drug coverage will be in plans with four and five stars in 2020, an increase from 69% in 2017. Star ratings for stand-alone Part D plans tend to have lower overall star ratings than do Medicare Advantage and Medicare Advantage Prescription Drug Plans.

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PROBLEMS WITH MEDICARE.GOV PLAN FINDER

The Medicare Plan Finder at www.medicare.gov is a tool that CMS provides to help consumers find health and drug plans and also to compare costs between Medicare Advantage, Medicare Advantage Prescription Drug, and Stand Alone Part D drug plans.

The site was changed and updated shortly before the start of annual enrollment.

We use the site primarily to determine clients’ annual drug costs (on a basis that combines plan premiums AND cost of medications). We’ve found there are many errors in the Plan Finder that have not yet been corrected and caution beneficiaries that in some cases they should not rely on the results they obtain by using Plan Finder. Costs for mail order drugs are not correct, and stated costs for some drugs are extremely unreliable. The error can be quite large. For example, estradiol has an average total cost of approximately $110 nationally but shows up on Plan Finder with a cost of over $1,000. As a result, beneficiaries who are not aware of these errors and make plan decisions based on Plan Finder results may inadvertently enroll in a different plan than they would have enrolled in had the data on Plan Finder been more accurate.

We strongly encourage beneficiaries to contact us at 877-734-3884 or 561-734-3884 for help in using Plan Finder to estimate drug costs and to determine those plans that will have the lowest overall total drug costs including the cost of the drugs and the cost of the plan premium. We cannot guarantee total accuracy but with our experience we can identify when there is a significant error in Plan Finder and can advise clients accordingly.

Beneficiaries can find more accurate information by going to a carrier’s web site and calculate drug costs using that site rather than using Plan Finder.

SENIORS SPEND THOUSANDS RETROFITTING HOMES TO AGE IN PLACE

According to an article published by Kaiser Health News on October 21. seniors are spending anywhere from thousands to tens of thousands of dollars to modify their homes so they can age in place. Surveys show that most older adults want to remain in their homes rather than move in with relatives or live in care facilities.

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DENTAL

MEDICARE

DISABILITY

LIFE

2020 Schedule
Affordable Care Act Open Enrollment

November 1, 2019 Open Enrollment begins.
December 15, 2019 is the last day to enroll for 2020 on the federal facilitated marketplace.
January 1, 2020 Coverage starts.

2020 Schedule
Medicare Annual Enrollment Period

October 1, 2019 Pre-enrollment period starts. 2020 plans can be discussed.
October 15, 2019 Enrollment starts.
December 7, 2019 is the last day to enroll for a 2020 plan.
January 1, 2020 Coverage starts.

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We offer a comprehensive set of Affordable Care Act (“Obamacare”) plans

to individuals and families qualified to buy health (tax- and non-tax subsidized) insurance and dental/vision and/or hearing plans through the Federal marketplace (this is called buying “on-exchange” or “on-marketplace”) or directly from insurance carriers (this is referred to as buying “off-exchange or -marketplace”). Our Affordable Care Act policies comply with the Affordable Care Act and contain all of the “essential health benefits” required by that law.

The dental/vision and/or hearing insurance

products are available both on an insured or discount basis

We offer short-term health insurance policies

for those who are looking for more inexpensive coverage and shorter term alternatives.

We offer Medicare Supplement, Medicare Advantage, and Part D Drug plans

to Medicare beneficiaries. Our site is compliant with federal, state, and carrier guidelines in selling these policies. See the Medicare section of this site for details.

We represent many carriers that offer supplemental benefits

to both individuals and families and Medicare beneficiaries, and the site contains information about hospital indemnity, cancer, critical illness, gap, accident, and international medical insurance offered by many different carriers. This section of the site also contains valuable information and tools about lowering the cost of prescription medications. Call us if you want more information about or would like to enroll in one of these products.

We also offer Short- and Long-Term Disability products

and can also help you meet the costs of long-term care, nursing home, or short-term (recovery) care needs.

Finally, we have a complete array of Life, Final Expense, and Annuity products

and offer pre-need services in Florida, as we have both life insurance and pre-need licenses in that state.

You pay nothing for our services:

we’re paid directly from the carriers we represent, Premiums are NEVER EVER marked up to include paying us for our services: you pay the same whether you order directly from the carrier or the marketplace on your own or directly through us or from our site.

We ONLY offer alternatives that are suitable for you and for which we feel meet YOUR needs.
When or if we feel a product or service is not appropriate for you from either a cost or benefit point of view we will tell you so.

We’re fully compliant with privacy and security guidelines, have signed all required privacy and security agreements, have developed a privacy and security policy, and take extraordinary steps to safeguard your protected health and personal information.
In short, we’re experts in all aspects of health and life insurance and also have relationships with professionals who can help you with very specialized situations.

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