IBM Medicare Via Benefits Be Aware of Medicare Advantage Bias in CMS literature

 CMS is the abbreviation for the federal government agency, Centers for Medicare and Medicaid Services,  that oversees Medicare.  This federal agency is responsible for publications, email messages and oversight of Medicare insurance policies and Medicare medical providers.

Over the years, many Medicare advisors have written extensively about the "disadvantage" of Medicare Advantage insurance plans.  I have pointed to some of those articles on this blog and written about the push, particularly in the last 4 years, by the federal government to get Medicare eligible participants to enroll in Medicare Advantage insurance plans.  It makes no sense, because these plans do not reduce the tax payer burden for the cost of Medicare. It would appear it is CMS's way to privatize Medicare and thereby get millions of dollars in campaign donations for the pushers.

A non-profit organization, Center for Medicare Advocacy (CMA), has been trying to hold the federal government accountable and expose it.  There are a huge number of pitfalls associated with Medicare Advantage plans.  Most of these insurance plans, to put it impolitely, suck.  Kaiser Permanente is about the only one worth considering but it is not available in many areas. 

  Here is a link to a recent "alert" document by CMA: 

https://drive.google.com/file/d/1dyJuWaxDOz9DcCKyiuPAT2-8mzYJJ7_K/view?usp=sharing

To access the file, at least when I tested it, I had to download it.

The bottom line - which I feel is sad - I DO NOT recommend you rely on federal government literature as your only source of education about your Medicare choices.  

There are several non-profit groups like CMA and Medicare Rights Center (1-800-333-4114) who offer a balanced approach to Medicare information and in MRC's case, provide Medicare counseling.  The  state health insurance assistance department for your state (which is found at www.shiptacenter.org) also typically provide honest assessments as that is not where insurance industry lobbyists spend a lot of time.  The library might also be a good source of Medicare information. What is not a good source of information?  Insurance agents, and, unfortunately, the federal government because they are both biased.

IBM Medicare Via Benefits Medicare Fall Enrollment for 2021 is Oct 15 - Dec 7, 2020

It's that time of year! Yesterday, I receive an "ANOC" for my stand alone prescription insurance plan. I have that kind of prescription insurance because I use original Medicare.  ANOC stands for "annual notice of change".  This year the thick booklet with all the information about the pharmacy networks and drugs covered by the plan in 2021 that usually are mailed as part of the annual notice of change were not sent.  Unfortunately it is even more likely people will throw out the notice.  Make sure to read your mail!

In the document, my prescription drug insurance said the drug and pharmacy information will be available on their website starting October 1,2020.  The days of quickly flipping through a thick booklet are gone and the likelihood people will go online to look for changes is slim.  My plan shifted the pharmacy information to a "Pharmacy Locator Tool".  That makes me wince.  Yet another thing to learn to figure out how the plan has changed.

More than ever, it is really important to make sure your prescription drug insurance plan is the best plan for you to have in 2021.  Drug insurance plans change from year to year.  Drugs are added.  Drugs are dropped.  Drug costs and deductibles go up (they seem to never go down).   Drugs that did not require "step therapy" - meaning trying a cheaper variety of drug before this one is approved - suddenly have a step therapy requirement.  Drugs that did not have quantity limits get quantity limits. 

YOU MUST CHECK HOW YOUR PLAN WILL CHANGE for 2021!!!!!! 

If you have a Medicare Advantage plan you have more work to do.  You must not only check the changes about prescription drug coverage, but also check the changes in medical coverage copays and medical provider networks.  One way to find out about provider network changes is to ask your current doctors if they will accept your plan in 2021.  Another way is to call your plan to find out the changes but their provider network directories are notorious for being wrong.  Make sure you write down the date you called, who you talked to and take notes on what they tell you.  Do this just in case you get incorrect information because you can use that to dump the plan if you find out they lied to you. 

Via Benefits might also help with some of this.  I am sorry to keep writing this but Via Benefits is an insurance agent.  The more products you buy through them, the more commissions they receive and you do not have to buy all your Medicare coverage from them. If you are on original Medicare and bought a medigap through them then you can change your drug insurance to the best fit policy for you and not have to worry about whether or not they sell the best policy.

Figuring out whether or not you have the best policy is not easy.  If you don't want to use a computer and go to www.medicare.gov to use the planfinder tool (ah, that lovely word again) then call 1-800-MEDICARE to as for help.  If you have a Medicare Advantage plan, then you need to call Via Benefits to pick from the set of Medicare Advantage plans they sell.

Reminder, for people with original Medicare and a medigap plan, this is NOT the time of year when you change your medigap plan.  Depending on the state where you live, you might not be able to change your medigap plan at all or you might be able to change it at specific times.  Check with your State Health Insurance Assistance Agency to find out the rules (their phone number can be found at www.shiptacenter.org).