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Medicare Advantage Open Enrollment Period (OEP), January 1–March 31; During OEP, you have a one-time opportunity to disenroll from your current Medicare Advantage plan and return to Original Medicare, or Switch from one Medicare Advantage plan to another.
Because Hoot is certified with numerous plans and not captive to any single plan, you benefit by working with someone who can find the plan that best suits your needs.
Now that you have received your Medicare card with Parts 'A' & 'B' and effective dates stated on the card, you are ready to start your search for a Medicare Advantage plan.
Generally, there is a number of plans in each service area or county. Medicare Advantage plans (also known as 'Part C') break down the counties by zip code. Some plans do not cover all zip codes in any particular county. So, when searching for a plan, zip code is the first criteria to check when making sure the plan is available there. Next, we want to determine if your Primary Care Physician (PCP) is in the plan network. These two criteria are important to verify at the outset of a search for a new plan. Why sort through plan benefits first, when the plan does not meet the first two criteria?
In each county, there is usually a couple of plans in your service area that includes your PCP in their network. Depending on demographics, there could be several plans in your county to choose from, sometimes less. For instance, there are many plans in Los Angeles County, CA, and fewer in Clark County, NV. Each of the plans in your specific service area offers different plan benefits and different monthly premiums. Sometimes, these plans can have very similar benefits. But, plan differences must be carefully disclosed by the representative so the Medicare Beneficiary (you) clearly understands the benefits stated in the enrollment application. Also, plans are Star rated by The Center For Medicare and Medicaid Services (CMS). Star ratings must be discussed when choosing a plan. There are important differences between 3.5 Star plans and 4.5 Star plans.
Before Hoot can discuss plan benefits with you, The Center For Medicare and Medicaid Services (CMS) requires that you sign a document that is called the 'Scope Of Appointment' (SOA). The marketing of Medicare Advantage plans is heavily monitored by CMS. In many cases, this is rightly so, as these plans are marketed to seniors who are subject to being enrolled in a plan they may not completely understand. The Scope Of Appointment is a form that states, "yes, I want Hoot to explain to me (the Medicare Beneficiary) either a Medicare Advantage Plan (MAPD) or a 'Part D' stand-alone prescription drug plan. Once this form is signed, Hoot can present 'plan specific benefits', but not until then.
Many Medicare Advantage plans (MAPD's) offer additional benefits (like the inclusion of a robust formulary 'Part D' prescription drug plan) that Original Medicare does not - and do so for a $0.00 additional monthly premium. Most Medicare beneficiaries must pay their 'Part B' monthly premium. If you aren’t collecting Social Security yet or will enroll in Medicare Part B in 2017, you will pay $134.00 per month.
Importantly to know, HMO MAPD plans (depending on the county you live in) do not (except for some PPO"s) charge an additional premium. In Los Angeles County and Clark County, NV, most of the HMO MAPD plans are $0.00 additional monthly premium. However, in Kootenai County, ID, for example, most of the plans charge an additional monthly premium. Premiums and benefits vary county by county. Another important note here; there is no guarantee in the future that MAPD plans will be able to continue to provide the managed care and additional benefits not found in Original Medicare for $0.00 monthly premium. ObamaCare shifted billions of dollars away from Medicare to Medicaid - which may make it necessary for MAPD's to charge a monthly premium in order to maintain plan benefits. But for now, let's hope not, but keep in mind premium amounts could change in the future.
What is clear, is that many MAPD's do a great job at providing incredible health care benefits to Medicare beneficiaries. When one studies MAPD plan benefits versus Original Medicare, it is hard to understand why more Medicare beneficiaries do not enroll in an MAPD plan. Why is this? Perhaps it is because just before turning 65, seniors are blasted with literature from carriers that can overwhelm them, or, they become confused by going over a half dozen plan brochures and the information sort of becomes a blur. Understandable. This is why calling Hoot for an appointment can make enrolling in Medicare Advantage a much more pleasant experience.
Veterans! If you have Medicare Parts A and B, call Hoot for an appointment to discuss the additional benefits available to you, or a loved one, by enrolling in a Medicare Advantage plan.
Hoot is certified with numerous Medicare Advantage plans. These plans include Part D, but this is an important point: If the Medicare beneficiary decides to stay in Original Medicare and does not enroll in an MAPD that includes Part D, they must enroll in a stand-alone 'Part D' prescription drug plan or they will incur a penalty. Medicare 'Part B' covers some drugs, but the list is limited, so Medicare requires the beneficiary enroll in a stand-alone 'Part D' plan if they do not enroll in a Medicare Advantage plan that includes 'Part D'. The 'Part D' national average for monthly premiums for stand-alone plans is about $35.00. So again, why would a Medicare beneficiary purchase a separate stand-alone prescription drug plan, when they can have a robust 'Part D' prescription drug plan already included in an MAPD, for $0.00 additional monthly premium?
What's Medicare Supplement Insurance (Medigap)? A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the healthcare costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.
Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.
A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy supplements your Original Medicare benefits.
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