October 28, 2024 Weekly Update

We do love it when someone refers a family member or friend to us.  Sometimes the question is, “How can we introduce them to you?”   Well, there are multiple ways but a very easy way is to simply forward them a link to this webpage.

Here are this week’s items:

Portfolio Update:  Murs and I have recorded our portfolio update for October 28, 2024

Medicare AEP in Retirement – 5 Things You Need to Know

Radon and Murs discuss the critical aspects of the Medicare Annual Enrollment Period (AEP) with Medicare Specialist, Shawn Southard. As we dive into Medicare AEP 2024, they explore why reviewing your current plan is crucial and how it may impact your healthcare costs, coverage, and provider networks. Shawn provides actionable Medicare enrollment tips that could save you money and ensure you have the right coverage for your needs.

 

Medicare AEP in Retirement – 5 Things You Need to Know

Medicare Annual Enrollment Period (AEP, October 15 to December 7, is one of the most critical times of the year for anyone who is eligible for Medicare. With the constantly evolving healthcare landscape, it’s crucial to understand your options and make informed decisions that align with your health and financial needs. Whether you’re already on Medicare or you’re about to turn 65 and eligible for the first time, the AEP offers a window of opportunity to review and adjust your healthcare coverage for the coming year….

Medicare AEP in Retirement – 5 Things You Need to Know

Medicare Annual Enrollment Period (AEP, October 15 to December 7, is one of the most critical times of the year for anyone who is eligible for Medicare. With the constantly evolving healthcare landscape, it’s crucial to understand your options and make informed decisions that align with your health and financial needs. Whether you’re already on Medicare or you’re about to turn 65 and eligible for the first time, the AEP offers a window of opportunity to review and adjust your healthcare coverage for the coming year.

But here’s the challenge: with all the choices, costs, and changes, how do you make sure you’re in the right plan? Are you prepared for potential Medicare plan changes in 2024, or aware of how your prescription drug coverage may be impacted? This blog will walk you through five essential tips you need to know during the Medicare AEP for 2025 so you can confidently choose the plan that’s best for you.

1. Review Your Current Coverage

Even if you feel comfortable with your current Medicare plan, it’s good practice to review it every year during AEP. Why? Medicare Advantage plans and prescription drug plans, also known as Part D plans, can change yearly. The insurance providers that offer these plans often update aspects such as premiums, copayments, coverage limits, and even provider networks.

In other words, you may have chosen a plan that was best for you in 2023 based on the options available. However, different options in 2024 may be even better, and how would you know without a yearly review? Insurance companies send out an “Annual Notice of Change” (ANOC) before AEP starts. This document will allow you to compare side-by-side what your plan currently offers and what will change in the following year. Be sure to review it carefully and bring it with you if you meet with a Medicare specialist. Making small adjustments could save you hundreds or even thousands of dollars over time.

2. Evaluate Your Costs

When it comes to Medicare, cost is often the determining factor in selecting a plan. However, the lowest-cost plan may not always provide the coverage you need. Medicare Advantage plans often come with varying premiums, deductibles, copays, and coinsurance amounts. Even plans that previously had a zero premium may introduce new costs in 2025.

For instance, in some cases, a $0 premium plan may start charging $15 or more monthly. Copayments for routine visits to primary care physicians could rise from $25 to $35, or the maximum out-of-pocket (MOOP) for 2025 could increase. This MOOP is the most you’ll have to pay for covered healthcare services within a year, and in 2025, the maximum out-of-pocket for Medicare Advantage plans is set at $9,400, significantly impacting those who may need extensive care.

If you are on a Medicare Part D drug plan, pay close attention to changes in the plan’s cost structure. Premiums may rise, or the tier system used for prescription drugs could shift, leading to higher out-of-pocket costs for your medications. Regularly reviewing and comparing plans can help ensure you’re getting the best value without sacrificing essential coverage.

3. Consider Added Benefits Beyond Medical

Medicare is not just about hospital and doctor visits—it also involves other valuable services such as dental, vision, hearing, and even fitness memberships. These additional benefits are often found in Medicare Advantage plans, but they can change yearly as well.

Some plans may scale back or eliminate certain benefits altogether. For example, a plan that included dental or vision coverage in 2024 may no longer offer those benefits in 2025. In some areas, Medicare Advantage plans include wellness programs like SilverSneakers, which offers gym memberships and fitness programs specifically for seniors. If these types of benefits are important to you, make sure they are still available in your chosen plan for the upcoming year. If not, you may want to switch to a plan that better meets your needs.

For those with Medigap (Medicare Supplement) plans, discounts on services like dental, vision, or hearing might not be part of the policy but can often be included as additional perks. This is why reviewing the fine print is essential during AEP.

4. Check Provider Networks

If you’re enrolled in a Medicare Advantage plan, your coverage is typically limited to a specific provider network. These plans often operate as Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs). Unlike Original Medicare, where you can visit any doctor or hospital that accepts Medicare, Medicare Advantage plans can limit your choices to specific healthcare providers.

Because these networks can change from year to year, it’s essential to confirm that your doctors and hospitals will continue to be in-network for the coming year. If a major provider leaves your plan’s network, you could end up paying significantly more out of pocket or being forced to switch doctors. Make sure to check that your preferred providers, especially if you have upcoming surgeries or treatments planned, will still be covered under your plan in 2025.

5. Review Prescription Drug Coverage

Medicare Part D plans, which cover prescription drugs, also change from year to year. In 2025, there are significant changes that will impact many Medicare beneficiaries. The maximum out-of-pocket (MOOP) for prescription drug coverage will drop significantly from $8,000 to $2,000. Once you reach this MOOP, you will pay $0 for covered prescriptions for the rest of the year, which is a massive benefit for those on expensive, brand-name medications without generic alternatives.

However, this reduction in out-of-pocket costs comes at a price for insurance companies, which will now be responsible for a larger share of prescription drug costs under the catastrophic coverage phase. As a result, premiums for Part D plans are expected to rise, in some cases by as much as 24%. This means that even if you’ve been happy with your current plan, you need to compare the new premiums and check whether your medications will still be covered at the same tier.

Additionally, drug formularies—the list of drugs covered by a plan—can change each year. If a drug you rely on moves to a higher tier, it could increase your out-of-pocket costs. Taking the time to compare plans and ensuring your medications are covered is crucial to avoid surprises at the pharmacy in 2025.

The Importance of Working With a Medicare Specialist

Navigating the complexities of Medicare can be overwhelming. Working with a Medicare specialist can make the process significantly easier. A specialist can guide you through the Medicare enrollment periods explained and ensure that you choose the right plan that fits your medical and financial needs.

At Peace of Mind Wealth Management, our team, including our Medicare Specialist Shawn Southard, is available to help you understand your options and ensure you are prepared for the upcoming year. Whether you’re a current client or new to us, you can schedule a complimentary phone call with Shawn or one of our advisors to review your Medicare plan and make sure it’s the best fit for you in 2025.

Schedule your complimentary call with us and learn more about “Medicare AEP 2025: 5 Things You Need to Know.” Remember, Medicare Annual Enrollment Period (AEP) is October 15th to December 7th.

By taking the time to review your coverage during the Medicare AEP, you can ensure that you’re getting the best value for your healthcare needs while securing your retirement plans and peace of mind.

January 8, 2024 Weekly Update

We do love it when someone refers a family member or friend to us.  Sometimes the question is, “How can we introduce them to you?”   Well, there are multiple ways but a very easy way is to simply forward them a link to this webpage.

Here are this week’s items:

Portfolio Update:  Murs and I have recorded our portfolio update for January 8, 2024

Understanding Medicare Advantage Open Enrollment in Retirement

In this Episode of the Secure Your Retirement Podcast, Radon and Murs have our in-house Medicare specialist, Shawn Southard, discuss the Medicare Advantage open enrollment. With an education background and a servant’s heart, Shawn is passionate about helping people find the right Medicare plans. Listen in to learn about the benefits of a Medicare Advantage plan and the reasons for the Medicare Advantage open enrollment period.

 

Understanding Medicare Advantage Open Enrollment in Retirement

Medicare is such an important part of your life as you age and secure your retirement, but it’s often overlooked in retirement planning. You may have to pay IRMAA surcharges and really need to begin planning to get the most out of your benefits. We’re happy to have had Shawn Southard on our podcast this past week to discuss Medicare Advantage Open and what it means for our listeners and clients.

 

Understanding Medicare Advantage Open Enrollment in Retirement

Medicare is such an important part of your life as you age and secure your retirement, but it’s often overlooked in retirement planning. You may have to pay IRMAA surcharges and really need to begin planning to get the most out of your benefits.

We’re happy to have had Shawn Southard on our podcast this past week to discuss Medicare Advantage Open and what it means for our listeners and clients. Shawn works in-house for us and will be helping all our clients with their Medicare needs.

Throughout the year, there are a lot of Medicare-related things that pop up that we really need to focus on. 

Note: Every month, we plan on having Shawn on the show to discuss questions that our listeners may have.

Medicare Open Enrollment Period

Medicare has quite a few enrollment periods that are easy to overlook. You can enroll when:

  • You turn 65 years old
  • You’re working past 65, retire and leave your health plan.
  • Annually, from October 15 – December 7 (this is when 95% of beneficiaries make changes to their plans)
  • January 1 – March 31st for Medicare Advantage policyholders, who can change plans or disenroll if they wish.

Medicare Advantage Open enrollment is what anyone reading this blog or who watched our episode will need to think about in January until the end of March.

What is a Medicare Advantage Plan?

Medicare Advantage plans, at a very high level, are often organized into parts by letters. But before we go into that, original Medicare is broken into:

  • Part A: Hospital coverage
  • Part B: Medical coverage
  • Part D: Prescription Drug coverage, optional but will incur lifetime penalty if not enrolled when eligible.

Part C is the Medicare Advantage plan. Medicare Advantage helps round out your Medicare. These are private plans that go through the insurance companies and are approved by Medicare. Each plan must offer the same Part A and B coverage as your original Medicare plan, but it is a private plan.

The Advantage plan offers additional benefits, such as:

  • Preventative Dental 
  • Preventative Vision
  • Hearing Exams

An Advantage plan may also combine your prescription coverage into the plan, but you’ll need to review each plan to learn more about the coverage offered.

Why Join a Medicare Advantage Plan Over Original Medicare?

A lot of you may be thinking, “Why would I switch from original Medicare to an Advantage plan?” One of the main reasons to make the switch is that original Medicare is only for things that are deemed medically necessary.

Medicare Advantage plans add in coverage for:

  • Annual physical exams
  • Dental cleanings
  • Eye exams
  • Hearing exams

Original Medicare plus a Medigap plan is an option, but this option comes with a premium that ranges from $130 – $150 per month.

Medicare Advantage has many great plans that have $0 premiums.

For a retiree, an Advantage plan often makes a lot of sense because they’re on a fixed income. 

Why Someone May Not Choose a Medicare Advantage Plan

Advantage plans seem very advantageous, but they’re also not for everyone. A downside of Medicare Advantage is that they are network plans:

  • Health Maintenance Organizations (HMOs), smaller network
  • Preferred Provider Organizations (PPOs), larger networks

You’ll need to go to someone in your network if you have an Advantage Plan. Original Medicare doesn’t have networks, so it’s easier for you to travel. You don’t need to worry about the provider being in network as long as they accept Medicare.

Medicare Advantage HMO requires you to stay in network. A PPO does have out-of-network options, but you may pay more for the services.

You need to consider the following when choosing a Medicare path (Original Medicare/Medigap or MedAdvantage):

  • Health
  • Lifestyle
  • Budget

Medicare is complex, and it’s easy to make a costly mistake along the way because of the amount of misinformation that exists. It is in your best interest to consult with a Medicare specialist before making any changes to your plan.

Why Someone May Want to Switch Medicare Advantage Plans

Since we’re in the enrollment period where someone can switch Medicare Advantage plans, the question arises: why would you switch plans?

Often, a person wants to switch Advantage plans because:

  • Doctors that they have been going to are no longer in their network, so they switch to a plan that allows them to retain the same doctor that they know and trust.
  • They plan to move and the new service area does not have their providers in network.

Shawn helps our clients choose the right plan for their medical needs and lifestyles. He has a strong educational background as a high school teacher and corporate trainer. In fact, his background as an educator is why he joined our team. He aims to educate each client, based on their individual needs, to find the best Medicare path.

Shawn needs to know your health/medical conditions, any prescription drugs you are taking, and your lifestyle (such as traveling) to help you select the right type of Medicare plan for you. 

Medicare is complex – especially if it’s not something you work with every day.

If you want to have an in-depth discussion about your Medicare situation and ensure that you’re on the right pathway, feel free to reach out to Shawn.

Click here to schedule a 15-minute call with us.