Open
enrollment season is underway for Medicare Advantage, and if you are one of the
4.5 million eligible seniors in Florida, you are going to want to shop around
this year for coverage that best fits your health and spending needs. For 2020,
more choices are available, as are lower premiums and co-pays that could save
you a bundle on prescription drugs and medical costs.
When it
comes to premiums, you will find that plans have become more affordable,
offering the lowest average monthly cost since 2007. For 2020, the average
monthly Medicare Advantage premium in Florida has dropped to $8.38 in 2020 from
$8.45 in 2019. Nationally, Medicare Advantage premiums in 2020 declined about
23 percent on average from 2018.
Seniors
often look to Medicare Advantage plans as a way to lower their healthcare
costs. With Medicare Advantage, the federal government gives funding to private
insurance providers running the plans selected by individuals as an alternative
to traditional Medicare. People who choose Medicare Advantage plans trade the
freedom of going to any doctor or hospital in the traditional Medicare plan for
an insurance company’s more limited network. However, Medicare Advantage
policies tend to include prescription drug plans and benefits such as vision,
hearing and dental.
Though
people tend to focus on premiums when comparing Medicare Advantage plans, David
Lipschutz, associate director of the Center for Medicare Advocacy, says they
shouldn’t choose on that alone. Once you’re in a Medicare Advantage plan, there
are other costs, such as deductibles, co-pays and co-insurance.
“You
have to look at what the plan charges when you actually use the services,” he
says.
Along
with lower premiums, there are more choices in plans this year and many are
rich with benefits. For 2020, there are 474 plans, with an average of 39 plans
per county, up from 33 in 2019.
Because
of the many changes, you will need to look carefully at your choices. Some 2019
Medicare Advantage plans within counties will be terminated or merged into
other 2020 plans. Miami-Dade, for example, will lose 17 of the 82 currently
offered 2019 Medicare Advantage plans. But in the same county, 14 new 2020
Medicare Advantage plans will be introduced. UnitedHealthcare, for example,
will offer 42 plans in Florida in 2020, including four new Special Needs Plans
in areas of the state including Central Florida.
“We
have tailored the plans to our member demographics,” said Roger Rodriguez, CEO
of UnitedHealthcare Medicare & Retirement in Florida.
Regardless
of whether you were satisfied with your 2019 plan, it is important to evaluate
annually whether that option remains the best for you.
“If you
are in an Advantage or Part D plan, your benefits can and will change from year
to year,” Lipschutz said. “Plans can get better and they can also get worse.
Look at your annual notice of change because what works for you this year is no
guarantee it will work for you next year.”
In
2020, most Medicare Advantage plans include drug coverage, and many offer
vision, dental and hearing exams. Beyond that, experts advise focusing on
benefits most critical for your needs when comparing plans. More than half of
all plans will offer additional telehealth benefits in 2020, and many offer
supplemental benefits tailored to specific needs such as adult care services or
caregiver support services.
Another
big change this year is the drug savings. You will pay no more than 25 percent
for both covered brand-name and generic drugs from the time you meet the
deductible until you reach the out-of-pocket spending limit in 2020 of $6,350.
Last year, you were required to pay a higher percentage for generics (37 percent).
In
Florida, 27 stand-alone Medicare prescription drug plans will be available, and
Medicare estimates that 95 percent of people with this type of plan will pay a
lower premium than in 2019 (about $30 in 2020 from $32.50 in 2019). Within the
state, $13.20 is the lowest monthly premium for a stand-alone Medicare
prescription drug plan.
Medicare’s
annual open enrollment period runs from Oct. 15 through Dec. 7. Medicare health
and drug plan coverage for 2020 begins Jan. 1, 2020. If you enroll in an
Advantage plan and change your mind, you can switch to a different Advantage
plan or to traditional Medicare once between Jan. 1 and March 31.
“Give
yourself as much time as possible to make an informed decision,” said Rodriguez
of UnitedHealth. “It’s important to understand whether your doctors and
hospitals participate with a plan you are considering, whether your medications
are covered and whether you are taking advantage of all the supplemental
benefits."
“Get as
educated as much as possible so you can make a selection on a plan that best
suits your needs,” he said.
One
South Florida resident discovered while comparing prescription costs online
that her current plan showed there would be more than $12,000 out-of-pocket
expense next year, while the second plan showed $0, and the third plan
estimated her cost at $360. She called the 24-hour Medicare helpline
(1-800-Medicare) and a representative explained that a one-time medication in
her profile had an annual retail cost of $37,000. By removing the drug from her
prescription list, she was better able to estimate real costs and compare 2020
plans.
“Having
someone walk me through it was a lifesaver,” she said. “If anyone has any
questions or needs guidance, I highly recommend they call and ask for help,
especially if you see numbers that don’t make sense.”
Cindy
Krischer Goodman can be reached at cgoodman@sunsentinel.com,
954-356-4661, Twitter and Instagram @cindykgoodman
(c)2019
the Sun Sentinel (Fort Lauderdale, Fla.)
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the Sun Sentinel (Fort Lauderdale, Fla.) at www.sun-sentinel.com
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