Another year, another fall open enrollment. I just received the 2019 information for my part D plan. The premium went up about 30%! That stinks. More importantly, a brand name drug is no longer on their formulary. The only way it is covered is by the generic, which doesn't work as well. Double, that stinks. Once again, I beg you to check the 2019 coverage for your Medicare part D to be sure it is still covering your drugs.
If it's time to find a new part D prescription insurance plan, the prices and coverage for the 2019 plans should be loaded by October 1st in www.medicare.gov but enrollment won't be activated until October 15. Since I already have a medigap plan with Via Benefits, I can buy any part D plan available in my zip code and am not restricted to just the plans Via Benefits offers.
I am hoping Via Benefits has a suitable part D plan - even if it isn't the cheapest plan I can buy. It seems interacting with this new service provider is no thrill. Although I chose email notification when I submit claims (I fax in claims), they seem to use a random number generator to decide whether or not to notify me they got the claim. I am also hearing from people that they are making mistakes such as double paying a premium and/or not paying some premiums. My biggest complaint about the switch to Via Benefits is the statements they send when they reimburse. I thought it was just me, but a few people have said "what the hell".... They are unintelligible.
This year I am also going to switch my medigap policy to F high deductible. I've played with the K plan and it was fun, but it really didn't provide much benefit and I am tired of the game. Also, as I have said in the past, F high deductible is going away in 2020 because the F plan is going away. I want to get it now and stick with it until I see what happens with the G high deductible offering.
There are other changes happening in 2019 such as new Medicare Advantage structures. There is also a horrid proposal by HHS to change how doctor visits are paid. They want to pay the same rate whether it a visit to a primary care doctor or a specialist. If enacted, it might become more difficult to find a specialist that accepts Medicare. As I have written in the past, HHS is making many changes administratively and not as a result of legislation. That, in itself, is making it ever more difficult to object to the changes. Here's a link to an analysis of some changes and proposed changes by the Medicare Advocacy Center. It's hard to read. I just skimmed it and my eyes started to roll around in my head: http://www.medicareadvocacy.org/wp-content/uploads/2018/09/Report.-Summary-2019-Call-letter-and-C-D-Rule-1.pdf
There is something else happening that is rather distressing. It seems health care providers have decided to partner with insurance companies to "push" their Medicare Advantage offerings. A provider group I use for some of my medical needs offers seminars on such policies. I have spoken to people who thought they were talking to someone from the medical group about what insurance to use and did not realize they were talking to an insurance agent from the insurance company. I have also tried to help someone who was in an assisted living facility who couldn't understand why they could not use the physical therapists at the facility. They did not realize when they moved to the facility they also had to buy the Medicare Advantage policy sold by the facility to have access to PTs and Home Care providers provided by the facility. They were not real happy because the primary care doctor they used was not covered by that plan.
I am even noticing that AARP is skewing their advice toward their Medicare Advantage plans in their newsletters. That's sad because they've aligned with United Health Care for years but were really pristine about keeping their advice unbiased.
The final thing I have noticed which is extraordinarily distressing, is insurance agents are becoming more ruthless about coercing seniors into switching insurance plans. Perhaps because of the attacks on the Affordable Care Act, insurance agents see an opportunity to do it. Last week, a woman with cognitive difficulties told an agent 4 times that she did not want an HMO, she wanted a PPO. She signed a lot of papers but did not have the wherewithal to be able to read them. When she got home she slowly started to read all the papers she had signed and realized she had been put into an HMO. She was lucky, she got Medicare to change it. Some people don't realize it until they go to the doctor.
Hopefully, the advice Via Benefits provides is not skewed, but keep in mind that it is their best interest for you to buy all your insurance from them. Thereby they get more commission. Make sure if you are trying to pick a new plan, you are getting advice from an unbiased source. 1-800-Medicare is unbiased, your state SHIP is unbiased (you can find yours at https://www.shiptacenter.org) and there are many non-profits offering advice such as www.medicarerights.org.
Happy fall open enrollment.
Sunday, September 23, 2018
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