Tag Archives: Part D Drug plan

Medicare Part D Drug Plan Premiums Lower for 2018!

Here is something you don’t see very often.  CMS who oversees Medicare has projected that the average Medicare Part D Drug Plan premium is expected to decrease in 2018!  Based upon the bids by insurers for their 2018 Drug Plans, the national average premium is about $1.20 less than 2017 national average of $34.70.

This is in spite of the fact that Medicare Drug costs are rising faster than other Medicare costs primarily due to high-cost specialty drugs.  So, while this is  not a lot, it is a change in the trajectory which is good.

You can read more about it at the article linked here:  https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-08-02-3.html

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

Causes of Drug Price Increases and What Can You Do About it?

We are all affected by drug price increases.  There are many reasons for this phenomenon but several factors have been more significant.  While we all want to know why this is happening, we also want to know what can we do.

As noted before, this issue arises a lot with my Medicare clients.  So, what can my clients do about it?  I have blogged before about some easy things to do such as:  ask your doctor for samples, shop around different pharmacies, ask for generics, etc.  I find the biggest thing to do is to compare your plan options.  If you are on a stand-alone Part D drug plan, you should shop each year.  If you are on a Medicare Advantage plan, you will need to consider both Plan medical benefits and drug copay costs.   Of course, I help my clients each year with these comparisons.  It usually starts with keeping drug lists current in Medicare’s comparison site where I can then help decipher the options including all costs (premium, deductible and copays).

A recent article goes into more detail on causes of increases. A link to that article follows:  http://khn.org/news/candidates-decry-high-drug-prices-but-they-have-few-options-for-voters/

The main takeaway for me was, people need a good Independent Agent who specializes in Medicare.  If you have questions about Medicare, call me, with no cost or obligation.  This is what I do and enjoy it.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

News Update on Mergers (Aetna/Humana & Anthem/Cigna)

Lately, there has been a lot of attention in the news to the pending mergers between Aetna and Humana as well as Anthem and Cigna.  The latest news is about the federal suits to stop the mergers.  The main thing I want my clients to know is that with or without the mergers, their Medicare Plan will remain in place.  This will mainly pertain to Medicare Advantage Plans and Part D drug plans.  If there are going to be changes, they will occur at the Annual Election Period (AEP) where they can make a change if needed.  In addition, if the merger(s) proceed, it will be years not months.  As usual, I will help my clients with this.

Feel free to call me with any questions as this process continues.  David.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

Medicare Beneficiaries Should Get in the Habit of Asking

Another constant reminder I recommend all my Medicare clients do is to always ask about prescription alternatives.   A recent study showed that doctors are easily influenced by drug company reps in what they should prescribe.  In many cases, these prescriptions are for costly Brand name drugs in which there is a lower cost alternative.  The study found that in many cases, a $12 complimentary meal to the doctor could end up costing patients hundreds of dollars more than the cost of a suitable equivalent.  I am not against the free market and how a company chooses to promote its products, but I want my clients to be aware of their choices.  If you want to read more about this study, you can click on the following link:  http://well.blogs.nytimes.com/2016/06/20/drug-company-lunches-have-big-payoffs/?_r=0

So, my recommendation to my clients anytime their doctor prescribes something, is to always ask the doctor if there is a generic or lower cost drug available, do they have any samples they can provide and if the drug is totally necessary.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

Medicare Patients are the Customers!

I am always reminding my clients, especially my Part C Medicare Advantage clients, that they are the Customer.  They can and should ask how and where they can lower their medical costs.  If a doctor prescribes a test, they should ask why it is needed and more importantly, where can they get that test done that will cost them the least based upon the specific Plan they have.  Most of us are not accustomed to asking our doctors these types of questions.  We think “they are the doctor, they should know best.”  In many cases they don’t have any idea of the variances in costs for certain medical tests.  Costs vary widely based upon where a test is administered and which Plan a patient has.

This is less of an issue for my Medicare Supplement clients; however, this concept of asking, also applies to prescriptions.  As almost everyone has a Prescription plan (whether it is a stand-alone Part D drug plan or it is embedded in a Medicare Advantage Plan), there are many variables to lowering drug costs.  Here too, ask for lower cost alternatives such as Generics and shop around at different pharmacies.  A recent article describing proof that both doctors and patients are missing opportunities to lower costs is linked below:

http://khn.org/news/by-not-discussing-cost-issues-doctors-patients-may-miss-chances-to-lower-out-of-pocket-expenses/

The bottom line is Medicare Beneficiaries should get in the habit of asking questions regarding how, where and when they can save money when something is prescribed.  I do it and I recommend my Medicare clients do it.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

Private Exchanges and Choices In Medicare

Many Retirees and other Medicare eligible beneficiaries will be directed to a Private Exchange to select their health plan benefits.  Typically, large employers and some large Benefits firms are getting into the Private Exchange arena.  The latest entrant is the financial services firm, Fidelity, who has announced this as a strategy.  A Private Exchange is similar to the Affordable Care Act Marketplace Exchange which was designed for people under 65.    An Exchange is merely a website that lists a person’s options and allows enrollment.  By itself, an Exchange is OK but there are some things anyone contemplating their options via an Exchange should be aware of.  I have reviewed some of the Exchanges and found a few common issues:

  1. The Exchange is going to be limited to a few plans from a few carriers. This means that there may be other options which could be lower cost that won’t be available.
  2. The people staffing the inbound phone lines are sometimes not experienced, independent Benefits professionals. Their knowledge can be limited to the training received for that call center role.
  3. Some of the information on the Exchange is either out dated and/or inaccurate.
  4. In many cases where the beneficiary is an employee, the employer contribution will only apply if the employee obtains their benefits through the Exchange. This could mean an employee must limit themselves to the Exchange options even though there may be better options available.
  5. The Exchange experience is not very personable. You are dealing with someone you don’t know in an unknown location.

So what is the alternative?  People like me usually allow you to avoid these pitfalls.  As an independent agent, I represent most or all of certain types of available plans.  For example, I represent all of the Medicare Advantage plans in Central Virginia and 7 of the largest, national Medicare Supplement companies.  In most cases, I can meet face-to-face and establish a better environment when making such important decisions and, at no cost to the client.

If you have questions about your Choices In Medicare, contact me at David@ChoicesInMedicare.com or visit our website:  www.ChoicesInMedicare.com

Happy New Year! – New Medicare #’s to Know in 2016

It is New Year’s Day in 2016 and that means new Medicare numbers to know for this year.  In most years, CMS, who manages Medicare, increases some of the costs associated with Medicare Part A, Part B and Part D coverages.  The following shows some of the key numbers that have increased for 2016.

  • Part A deductible – Will be $1288 from $1260 (per 60 day Benefit Stay)
  • Part B Deductible – Will be $166 from $147 (Annual deductible)
  • Part B Premium – Will be $121.80 from $104.90 (Will not apply to existing 2015 beneficiaries who have it taken out of Social Security)
  • Part D Maximum Deductible – Will be $360 from $320 (Some plans don’t have a deductible)
  • Part D Premium National Average – Will be $34.10 from $33.13 (Is used to determine Part D Penalty)

While none of these are dramatic, it is still important to be aware of the changes.  Also, even with these increases, Medicare coverage and any applicable Supplemental coverages you may have is great coverage.

You can read more about this topic at Medicare.gov website by clicking on the following link:  https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-11-10.html

If you have questions about your Choices in Medicare, please contact me at David@ChoicesInMedicare.com or go to www.ChoicesInMedicare.com

2016 Medicare AEP Opens Oct. 15th Through Dec. 7th

It’s that time of year again for Medicare beneficiaries.  The 2016 AEP, or Annual Election Period, is the one time per year when Medicare beneficiaries can change their Medicare Advantage Plan or Part D drug plan without needing a special election period.  People who have a Medicare Supplement policy do not have to do anything with their policy unless they want to change their prescription plan.  The AEP begins Oct. 15th and runs through Dec. 7th.

Keep in mind this is also the only time the insurance companies can make changes to their plans.  If they do, they will send the member an Annual Notice of Change (ANOC) describing the changes for the upcoming year to be effective on January 1st.

If beneficiaries have questions or want to make changes, they should contact their insurance carrier or agent.

Or, they can contact David Higgs of Choices In Medicare at David@ChoicesInMedicare.com with questions.

Advantages of an Independent Medicare Insurance Agent

Again, I have completed all of my re-certifications for the upcoming AEP to continue being eligible to offer all of the Medicare Insurance plan types in Virginia.  This includes Medicare Supplement plans (Medigap), Part C Medicare Advantage Plans and Part D drug plans.  I have the re-certifications for all of the available Medicare Advantage plans and most Part D drug plans for the Central Virginia area as well as 7 of the most well-known Medicare Supplement plans.

It occurred to me what an advantage this is for clients and prospective clients who contact me with questions about enrolling in Medicare.  As an independent agent, I don’t work for any of the insurance companies, but am licensed, appointed and certified to represent the major Medicare insurers.  This means I can help people navigate through the many options available to them.  I become a one-stop resource instead of them having to contact multiple insurance companies one by one.  Without any bias towards any particular insurance company or type of plan, I help people find the best fit for them based upon their particular circumstances.  And, I don’t cost my clients anything.  You can imagine what they would get if they contacted an insurance company direct.

If you have questions about Medicare, contact David Higgs at David@ChoicesInMedicare.com or go to website: www.ChoicesInMedicare.com.

Part D Drug Plan Penalty

In helping seniors select a Part D Drug plan (PDP), I find a lot of people are confused about the Part D Penalty.  In short, it is a penalty for those that don’t elect a PDP when they are eligible and don’t have other Creditable Drug coverage.  While Medicare will not require anyone to enroll in a PDP, they will assess a penalty of 1% for every month they didn’t have coverage.

For more info on what the penalty is and how it works, you can go to the link below that explains in more detail at Medicare.gov.

http://www.medicare.gov/part-d/costs/penalty/part-d-late-enrollment-penalty.html

For questions about selecting a Medicare Plan, call David Higgs at 804-972-4997 or email: David@ChoicesInMedicare.com.