Medicare Open Enrollment is Here! - Check Out What's New for 2020

What Else Is New For 2020? Will Medicare Supplements be covering Vitamins? Gym Memberships?

This Medicare Open Enrollment Season gives 15 minutes time to check for perfection

Scenario:

Jerry and Lois have been on Medicare since 2006, it was the first year that Medicare Part D prescription drug coverage came into effect. Jerry’s prescription usage hasn’t changed much, but through the years we have noticed an impact. For instance, one year the best plan fit for him cost $1774 per year for his particular line-up of maintenance drugs (which includes the cost of the Part D insurance premium). The next year, that same plan continued to merit his business, but in third year, had he stayed on that same plan (same Rx’s), his annual cost would have gone up to $2056. And paying attention, in third year we found another plan on the market for Medicare Part D that was able to save him considerably. Same prescriptions, same pharmacy, we were able to move him to the new plan and his annual Rx costs dropped to $976 a year (again, including the price of his monthly insurance premium).

Why is there such confusion and why is it necessary to pay such close attention to this? We ask ourselves this question too. But reality is that each year, for millions of Medicare recipients nationwide, we have from October 15 to December 7th to look at the new plans, their drug formularies, and using our best guess of what we will be using Rx-wise in the coming year, we are tasked with doing this quick research. If you’re on a plan, that plan will send out a package, but with 30 Part D drug plans available in 92649, and 43 Medicare Advantage plans (most with prescription coverage), that 15 minutes could save you a great deal of “Prior Authorization” nuisance tasks and well, time & dollars.

The Rx deductible was $250 in 2006 and now in 2020 the deductible will be $435. However so many of the drug plans waive the deductible for certain prescriptions (maybe yours). The “Coverage Gap” is disappearing – no more doughnut hole. Instead there will be a sharing of expenses throughout, and in the event that someone were to reach a shared total (remember Medicare assesses the drug’s full cost as measured by YOUR drug plan to this calculation), then after $6350 is spent, catastrophic for 2020 will be $3.60 for generics and $8.95 for brand name Rx’s or 5%, whichever is greater.

Interestingly, the market is changing everything: We have Medicare Supplements now offering coverage for vitamins, where Part D drug plans are not permitted to. We have some Medicare Advantage plans stepping in and saying they are making those very expensive Tier 6 drugs free because they realize they are lifesaving and terribly expensive.

And we also have MACRA. MACRA legislation was passed in 2017, and most have seen wave one: The Medicare ID card no longer has a social security number on it. Instead we have 11 digits (impossible to memorize, I’m hearing), but safer.

Those born 1955 or later (if you’re not on Medicare by 12/31/2019) you cannot get a Medicare Supplement “F” plan. The best you can get is a “G” (so you have the currently $185 Part B deductible to meet). However, those who are on an “F” plan now (the best plan currently sold), can continue to use the birthday rule and make a lateral move to any other company’s plan. So, we still have many companies open for business for “F” plans (although Blue Shield closed their F deductible to new members effective Oct 1. Anthem did the same about 10 years prior, but we have several seniors happily on their Anthem F-deductible plans to this day.

Rates change, new lower rates, more comprehensive plans have reached the market. It’s good to pay attention.

Surf City Financial Group will have extended hours through the season, and we have lots of materials here and are happy to help. Call or stop in. We are located on 15205 Springdale Street and can be reached at 714-377-1400. I am sure you would want to hear, “You’re on the best plan for 2020,” as you are leaving our office!