One of the most important times of year for every person on Medicare was the Medicare annual election period, which runs through October 15th to December 7th of every single year. During this time Envizion Insurance sees many clients and helps them decide on which plan to move forward with. The most common question that your Plymouth insurance agent is asked is, “What is the best plan?” The answer that you’re going to get from your Plymouth insurance agent is, “It depends.”
The reason this is the answer to that question is because there is no one size fits all plan when it comes to Medicare advantage plans. There are a bunch of options available to people on them and there’s really sort of four key factors that we really like to focus on that really help people decide if a one plan is going to have the coverage they need compared to the current plan they’re on and if there’s any benefit in changing the first portion and the most important is if your doctors are going to stay in network in the plan that you’re looking to switch to. Many people have been with doctors for a lot of years and are comfortable with them and the doctor knows their situation, knows their history and if a person switches plans and no longer can see their primary care physician that they have seen for a long time, this could be a huge cause for concern.
So as part of the process, I’m always checking doctors for every single person we meet with to make sure that any plan they’re looking to switch from and switching to a new plan, that that new plan has all the doctors that they required to have in network. If you’re going to have a plan that has your doctor’s out of network, you’re going to be paying significantly higher prices. That doesn’t mean maybe if one of your doctors is out of network that isn’t. That is a bad idea to change, but it does mean that you need to seriously look at the plan and make sure that the majority of your doctors are in network and especially those that you see on a regular basis and that are sort of a make or break sort of doctor for meaning. If you cannot see them at an a network price, that it will be an issue.
The second part that we always look at and is also almost just as important as the doctors are prescription costs. Since every plan has their own formulary for prescription costs and tears, it’s important to make sure that when switching plans that you check the prices of your prescriptions. Prescriptions could be a much lower price on one plan compared to the next and in some cases some prescriptions are simply not covered on one con plan compared to the one that they’re currently on as your Plymouth insurance agent, we are here to help you find a plan that’s going to meet your needs and by not checking those two things right off the bat before going into any bigger details of the plan and those copays and different things like that, we would not be doing our job.
The next part that your Plymouth insurance agent always checks and always shows people is what’s called the maximum out of pocket. This is another key feature of a plan because this shows and determines the amount of out of pocket expenses that someone would have to pay. In a worst case scenario, medical situation, the plans vary and how much this is and they can vary by a few thousand dollars per year, meaning that on one plan you may pay $5,000 for all expenses for a year and another plan could be $3000 so essentially if the worst case scenario happened, you could have a savings of $2,000 on just the maximum amount of pocket. So that is a very important thing that we have people look at because it shows a sort of safety net or high end number limit for medical coverage that they would have to pay if the worst case scenario happens. As your Plymouth insurance agent, we always like to prepare you and make sure you understand what the worst case scenario would look like, and always hope for the best in every situation, but also make sure that you’re safeguarded if that worst case scenario happens.
The next thing that your Plymouth insurance agent looks at is the plan deductible. In Minnesota. For most cases, Minnesota Medicare advantage have $0 dollar deductible but that is not always the case. So this again is a very important piece of reviewing your plan. If one plan has $1,000 deductible, meaning you would have to pay $1,000 out of your pocket in the beginning of the year before you received any of the lower co-payment costs of the plan compared to another plan where there’s a $0 deductible. That may be a huge difference for someone and it cannot be overlooked. Of course there are a lot of different copays for each different plan and those are important as well, but these are sort of those bigger picture key features that we always make sure of right away. The nitty gritty details will always be reviewed as well, but these are sort of those red flag ones that if you see right away, you know plan may or may not be beneficial for you compared to the plan that you’re currently on.
Also, another portion that your Plymouth insurance agent always like to look at are ancillary benefits. These are benefits such as dental vision and eye coverage that one plan may have compared to another. Many plans have options to pay for these extra and other plans do have the option of having some coverage that’s included in the base price premium per month on the plan. Although these can be kind of an icing on the cake sort of thing, it can be a big difference in how someone wants to approach their next year of medical coverage. One thing we do also tell people is to never solely make a decision on a plan based on those extra benefits. The reason being is if you decide on a plan that has some extra dental coverage, but all of your doctors are not in network or there’s a high deductible on the plan, you’re going to put yourself into a much tougher situation then the plan that you’re currently on. If those things such as deductibles and doctors being in network are a better fit for you on that plan.
So as you approach the annual enrollment period, these are a few of the features that you can look at at your in your current plan and compare with other plans that you’re looking at and possibly thinking about switching to. It’s always best to sit down with a professional like your Plymouth insurance agent at Envizion insurance to make sure that all the fine details and all your questions are answered and that you fully understand the plan that you are going to switch into before you do that has your Plymouth insurance agent. We are here to make sure that the annual election period is a smooth and easy process for you and that all of your questions are answered, that you feel comfortable about your plan, whether you switch into a plan or not. Our goal is not to just change a person just to change them. Our goal is to make sure that changing a person provides some benefit or puts them in a great position for the next calendar year for medical prescription coverage. If you ever have questions about your plan or I’d like to go through this review, please let us know and we’ll have a Plymouth insurance agent from Envizion Insurance work with you to go through these pieces of your plan and help you in any way that you need help.