Tuesday, September 29, 2015

IBM OneExchange Medicare Reminders - OneExchange insurance offerings

If you are on Medicare (meaning you are over 65 and are retired from IBM) you probably got an email from OneExchange about Medicare's open enrollment which is October 15 - December 7. This enrollment period is dictated by Medicare and happens every year.  It is the time of year to analyze whether your Medicare part D insurance (for prescription drugs) and/or your Medicare Advantage insurance (for those not using original Medicare) still match your needs and, if not, to switch to new insurance coverage to begin in 2016.
Reminder: Medicare open enrollment DOES NOT apply to Medicare supplement insurance policies (aka medigaps).  The rules for when or if you can change to a different medigap policy are determined by where you live (the state).  For example, in California you can change 30 days starting with the day of your birthday but there may be a preexisting condition coverage waiting period of up to 6 months.  In New York, you can switch medigaps any time and the change will be effective the beginning of the next month. In other states there is no change window and you are at the mercy of the insurance companies to decide if they want to sell you a policy. There have been many requests to Congress to federalize medigap enrollment but so far it has fallen on deaf ears.
Reminder: OneExchange is an insurance agent.  They sell Medicare insurance policies that pay them commission.  They do not sell all the Medicare insurance policies that are available for to you to buy. Buying insurance from OneExchange is like buying a car from a Toyota car dealer.  They are only tell you about what they sell.  HOWEVER, you must buy one heath or drug insurance policy (Dental and Vision insurance doesn't count) from OneExchange to get your IBM health retirement benefit. .  For example, if you bought a medigap policy you qualify for your subsidy.
Reminder: Go to www.medicare.gov  beginning on October 15, 2015 and use "Find a Plan" to see the complete list of insurance policies available for you to purchase in your zip code.  Insurance companies decide what policies to sell by zip code demographics because the "younger" the Medicare eligible population the better.  It's akin to insurance companies that sell flood insurance in locations that do not flood.
Reminder: Part D and Medicare Advantage insurance companies change their policies from year to year. They add or remove drug coverage to formularies or change tier pricing. They change pharmacies. They add or remove doctors from their network (Medicare Advantage plans). They change co-pays.  Read all the literature your existing company sends to you.  Frequently the literature will say "we changed our pharmacy network".  That's all they legally have to do to notify you of a change.  You have to then figure out the details.  Call them  and go to www.medicare.gov  to see what they changed.

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