Seniors may choose Medicare Advantage plans for a number of reasons including:
• They may have the opportunity to purchase a zero-premium plan.
• They can combine medical and prescription drug coverage through one plan similar to coverage they had while working, for example, through an HMO (health maintenance organization).
• Their employer-provided retiree plan is a Medicare Advantage plan, allowing them to receive coverage through their former employer.
• They may have access to broader, more extensive healthcare coverage at a cost comparable or less than original Medicare, depending on where they live. The average Medicare beneficiary will have 20 plan options, which break down to 10 HMOs, two regional PPOs, four local PPOs, two PFFS plans, and other plan types2 (PPO – preferred provider organization; PFFS – private fee-for-service).
• These plans provide a limit on out-of-pocket spending; for instance, nearly half of all Medicare Advantage plan participants purchase plans with an out-of-pocket limit of $3,400 or less.3
In addition to comparing original Medicare with Medicare Advantage plans, many seniors shop for Part D prescription drug coverage during annual enrollment.
Depending on where they live, seniors could have 20 to 30 or more Part D plans from which to choose. Monthly premiums also vary widely, ranging on the low end from $15 up to $165 on the high end, amounting to a possible $1,800 cost difference for the year.4
Timing Is Critical To Navigating Medicare Maze
Based on the questions your clients have and the possible factors in their Medicare choices, it’s easy to see why there are benefits to getting started early with Medicare annual open enrollment. In addition, many Medicare Advantage and Part D plan providers begin mailing out materials about next year’s plans in September.
Taking time this summer to assist clients with outlining their needs, experiences in 2013 and expectations for 2014 will place them on good footing for Medicare annual open enrollment. It’s important that individuals clearly understand their personal circumstances and healthcare needs, then work on finding the plan that best matches those needs—instead of vice versa.
The 54 days of Medicare annual open enrollment, from Oct. 15 to Dec. 7, isn’t really very long to help your clients make those critical choices that will shape their healthcare and financial experiences in 2014.
Paula Muschler is manager of the Allsup Medicare Advisor®, a nationwide Medicare plan selection service that helps financial advisors ensure their clients choose the Medicare coverage that best matches their needs and preferences. Allsup Medicare Advisor® is an unbiased Medicare plan selection service that serves as a trusted resource for financial advisors and seniors. Allsup Medicare specialists can work with your clients one-on-one to assess their needs, research their Medicare options and help them choose cost-effective coverage that protects their health and retirement savings. Financial advisors may contact (888) 220-9678 or go to FinancialAdvisor.Allsup.com for more information.
1Kaiser Family Foundation (KFF), “Medicare Advantage 2013 Spotlight: Enrollment Market Update,” June 2013.
2KFF, “Medicare Advantage 2013 Spotlight: Plan Availability and Premiums,” December 2013.
3Ibid.
4KFF, “Medicare Part D Prescription Drug Plan (PDP) Availability In 2013.” November 2012.