I’m updating this post regarding finding the best Advantage plan for you.  I now have an easy navigation tool to help you compare plans yourself.  Please check it out by clicking the “Compare and Enroll” button on the homepage of my website at https://clementeagency.com.  You can compare plans, or be further adventurous and enroll in the plan of your choosing.  If you need help determining if your doctors are in network with the plan, or if you have problems getting your prescriptions entered enabling you to see their costs, please give me a call and I’ll help with no obligation.   This is a great self-help tool, but I’m always willing to support and assist with your efforts.  Feel free to contact me.

Sharon Clemente – October 21, 2020

Are you confused with all the advertising on TV, the calls you’re receiving, and the mail box full of mail ads you’re getting?  It’s daunting!  There are different ways to get Medicare supplemental coverage.  You might choose a Medi-gap plan along with a Stand-Alone Prescription Drug Plan or you may be more content with an Advantage Plan. This article deals with the key to finding the best Medicare Advantage Plan.

If you already have a Medicare Advantage Plan, it’s important to read your plan’s Annual Notice of Change document you received in September.  This document explains all the benefit and cost changes from 2020 to 2021.  Some may be good and some may not be so good, or the changes may be minimal.  Being armed with this information is an important step in determining the right plan for the upcoming year.  From this document you can find:

• If the premium, deductibles and co-insurance/copay amounts are changing
• If the annual maximum out-of-pocket amount is changing

If you feel it may serve you best to look for a new plan, the answer lies in the words “the BEST plan for ME”.  Your neighbor’s plan may not be the best plan for you because he or she may see different doctors and depend on different medications. You need to know what to look for and that means that you need to do the research.

You need to find the following:

• Is there a monthly premium?
• What are the deductibles and co-insurance amounts?     
• What is the plan’s maximum-out-of-pocket amount? 
• Does the plan include my doctors in the plan’s network?
• Are my prescriptions included in the plan’s formulary and on what tier, and are there restrictions on my medications (prior authorizations, step therapy rules, quantity limits?
• Does my plan have gap coverage?
• Is my pharmacy a preferred pharmacy so I pay less for my prescriptions, and what mail order pharmacy can I use?

To begin your search, you can go to https://www.medicare.gov/, click the “Sign Up/Change Plans” blue button on the top left of the page and then choose “Find health & drug plans” from the drop down menu. At this point you can either click “log in or create account” or choose to click “Continue without logging in.” 

You’ll then answer a few quick questions before continuing to input your medications and following through to see a list of plans.  This list of plans for comparison are already sorted by “lowest drug and premium cost” and you can choose to see “Plan Details” of the listed plans you want to pursue.  At this point, on the bottom of the page you will see “Contact Information” where you can click “View plan website”.  If you do this, you will be taken to that particular plan’s website where you can check if your doctor is in the plan’s network and also enter your prescriptions to confirm they are on the plan’s formulary, their cost, and if there are any restrictions. 

Happy hunting!  But, you can “cut the chase” and get the free assistance of a broker who will do the work for you to find the plan you need, help you enroll, and then be available to answer your questions and give ongoing support.

If you need help understanding Medicare benefits and health insurance options, contact The Clemente Agency in Gilbert, AZ. Licensed insurance broker Sharon Clemente brings over 14 years of industry experience to help you get the coverage you need and will help you fully understand available plans. Visit them online or call (480) 209-2250.