Wednesday, August 24, 2016

IBM evaluating 2017 Medicare health insurance choices

The time of year to reevaluate your Medicare health insurance options is rapidly approaching.  Between October 15 and December 7 you have the opportunity to switch to another plan.  In September, insurance companies that offer Medicare Advantage plans will mail out 2017 plan information to current recipients as well as do intense marketing to try to get people to switch to their plans. The TV ad campaign is almost as intense as it is for the presidential election!  Be sure to READ and KEEP the information you receive from your current insurance providers.

Don't wait until the end of November to consider your choices.

First and foremost - remember that you only need to buy ONE medical plan from OneExchange to get your IBM health insurance benefit.  It has to be a medical plan - dental and vision don't qualify as health insurance.  Medicare Advantage plans, Medicare Supplemental plans (aka medigaps) for original Medicare users, and Medicare prescription drug insurance plans (part D plans) are what they mean by medical plans.

Secondly, Medicare Advantage plans and part D plans CHANGE their plans from year to year.  They cannot change the medical procedures they will cover (that is dictated by the government) but they can change who provides services. Medicare Advantage plans add or delete doctors, specialty clinics and change copay amounts.  Part D plans add or remove drugs they will cover and/or change the tier pricing for the drugs they cover. MAKE SURE you know what your coverage will be and switch if you don't like their 2017 changes.

I continue to believe original Medicare, a Medicare supplemental (medigap) plan and a separate part D plan offer maximum flexibility.  You can go to any doctor or specialty clinic anywhere in the USA.  You can pick a drug plan that best matches your prescription needs.  If you want to switch away from a Medicare Advantage plan to original Medicare and a medigap plan it is important to know whether you can get medigap coverage in your state without underwriting for preexisting conditions or premium adjustment for preexisting condtions.  States like New York and Connecticut don't allow such stuff.  Contact your state agency for more information:

Insurance companies are going through a lot of reorganization and consolidation to maximize their profit to stakeholders. For example, Aetna is a FOR PROFIT company.  You may have heard the news coverage about them. They are loudly wailing about how much money they've lost providing Obamacare insurance plans in rural areas.  That doesn't mean they aren't making profit.  They are still very profitable.  However, it appears (from the volunteer work I do) they are now squeezing all their plan holders (Medicare or otherwise) by routinely denying claims for obscure reasons to try to make up for what they've "lost" in rural coverage costs.  Make sure you not only understand your insurance provider coverage, but also look at the Medicare star ratings and the online chatter about the service of your insurance provider.  The nice thing about original Medicare is it is the government insurance pool.  There still is pressure to reduce cost (by congress) but there are no stakeholders looking for maximium profits.

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