Written by Melinda A. Caughill, Co-Founder, i65
updated for 2023
Each year, Medicare Advantage or Part D drug plans can make significant changes for coming year, including monthly premiums, the medications they cover (or do not cover), how much you’ll pay for each drug, pharmacy networks, doctor networks, out-of-pocket costs, deductibles and more. As a result, it’s critical that seniors review their plan options during Medicare's Open Enrollment period between October 15 and December 7 of each year.
Unfortunately, according to a consumer study on Medicare, only about 10% of seniors actually review their Medicare coverage annually. This could be costing you — even thousands or tens of thousands — of dollars. In fact, in 2022, clients of 65 Incorporated getting plan review services saved an average of almost $7,300 each! And, one lucky client saved more than $176,000!
Considering, though, that most people find it painful to review their Medicare coverage, what's the best way to get this information without incurring unnecessary frustration or annoyance?
Triage Your Open Enrollment Needs With 3 Simple Questions
The need to review Medicare coverage is much greater for some people than others. Those who answer yes to any of the following three questions would benefit greatly by reviewing their coverage during Open Enrollment.
1. Has it been more than 2 years since you last reviewed your Medicare Part D or Advantage plan? The longer it's been since you've reviewed your coverage, the greater the urgency to review your coverage now. The average savings is about $350 per year since the coverage was last reviewed. (Example: 5 years without review equals an estimated potential savings of $1,750.)
2. Has your health changed since you last reviewed Medicare plans? A change in health usually means that you are seeing new doctors or specialists and/or taking new medications. When people initially pick Medicare plans, they do so based upon their current needs. When those needs change, it's critical to review your coverage. (Example: The senior now has Type 2 Diabetes and takes insulin regularly. The insulin taken is not covered by the current plan costing about $1,500 per month, but it could be covered if the senior switched plans.)
3. Do you take any brand name medications or do you take 5 or more medications in general? The more medications that you take, the more likely you are to save money by changing plans for the coming year. But, if you take any brand-named medications (even just one), it's still critical to review your coverage. A single brand-name medication can be thousands or tens of thousands of dollars less on different plans.
4 Ways to Get Assistance with Medicare Plan Reviews
Choose the option that works best for you:
1. Compare plans using the Plan Finder tool at Medicare.gov. Can you actually compare plans yourself? The simple answer is YES! Using the Medicare.gov Plan Finder tool and the step-by-step comparison guides available through i65 membership, including worksheets and instructional videos, you can help your clients make the decisions that are best for their unique needs. For those who are interested in this option, know that you may charge a fee for service, if you so choose.
2. Consider offering unbiased, expert plan review assistance. Professionals with an expertise in Medicare can offer plan comparison services on a fee-for-service basis. Any professional working on a paid basis is not allowed to also make commissions from the sale of Medicare insurance products. 65 Incorporated is one such company that provides unbiased, expert plan review services. Through a Medicare Tune-Up™, your clients get specific plan recommendations based upon their unique needs. These recommendations are delivered in a PDF report that detail the cost, coverage and quality factors of up to three of the best plans in their area. This service is $149 for a Part D drug plan review or $249 for a Medicare Advantage plan review. Through the i65 software, services are available at discounts of 10-30%.
3.
Talk to local insurance agents, pharmacies or government resources.You may access Medicare services through your local State Health Insurance Assistance Program (SHIP). This program provides free Medicare counseling provided by volunteers. Please note that services and their availability vary greatly by location.
If you choose to use a local insurance agent or pharmacy resource, be sure to qualify that professional first. For insurance agents, it’s important that the agent will recommend the plan that is in your best interest regardless of whether that plan is one the agent sells. If the resource you choose to use is a pharmacy, be aware that you will only see drug prices at that specific pharmacy. Often, you could save hundreds, if not thousands of dollars, simply by switching pharmacies. But, this is not something you will learn through a plan review done by a pharmacy. Ideally, if you prefer this option, you would get reviews from two or more pharmacies.
4. Learn some basic information about the Medicare Open Enrollment period. You can find some basic information about Open Enrollment through Medicare.gov. However, if you prefer something more user-friendly, our parent company, 65 Incorporated, offers many free, helpful resources through the library section of their website. Our favorites include the "Open Enrollment Q&A" whitepaper and an infographic about the importance of reviewing your coverage during Medicare's Open Enrollment period.
Whichever option you choose, pat yourself on the back. You're doing something that most people enrolled in Medicare never do.
If you discover savings and want to share the good news, let us know! We love to share in the joy of saving money on Medicare.
