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The Top 10 Questions about Medicare (and How to Answer Them)

Posted by Paul Rose on 9/25/19 12:40 PM

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As you know, it’s almost time for Medicare’s Annual Election Period. This means that Medicare beneficiaries – approximately 60 million of them – will have plenty of questions about their coverage. Here are the top 10 questions you’ll get asked, as well as how to answer them.

Of course, as a Medicare agent, you already know the answers to most of these questions, but have you been sharing the answers? Consider posting these QAs to your social channels (one at a time) to spark interest and further questions from your social network.

1. When is the Annual Election Period?

The Annual Election Period starts October 15 and ends on December 7. Selections made during this time will go into effect January 1.

2. What can I do during Annual Election Period?

Medicare beneficiaries can make changes to their coverage for the following year.

  • They can switch from Original Medicare to Medicare Advantage.
  • They can switch from Medicare Advantage to Original Medicare.
  • They can switch from one Medicare Advantage plan to another Medicare Advantage plan.
  • They can change, drop, or enroll in a Medicare Prescription Drug Plan. (Many Medicare Advantage plans include prescription drug coverage)

3. Is my current plan changing?

It is very possible that a client’s current plan will undergo some changes for the following year. The plan should send out an Annual Notice of Change during September. This letter will outline any changes to the plan.

4. What if I like my current plan?

If your client is happy with their current plan, they can keep it. However, it’s still a good idea to take advantage of AEP to review coverage. There may be changes to the plan that impact its suitability. Additionally, there may be new plan options that the client likes even more.

5. What other plans are available?

The number of Medicare Advantage plans has been increasing. CMS reports that there were about 3,100 plans in 2018 and about 3,700 in 2019, and there were 34 choices per county on average.

Medicare beneficiaries can use the Medicare Plan Finder to look at Medicare Advantage and Medicare Part D plans in their area. As a licensed Medicare agent, you can help them find suitable plans.

6. What will my out of pocket costs be?

The standard Medicare Part B premium in 2019 was $135.50. Some people paid more based on their income bracket. The Medicare Part B premiums for 2020 will be announced soon.

Some Medicare Advantage plans do not cost anything beyond the Medicare Part B premium, but some do require an extra premium. The average Medicare Advantage premiums have actually been decreasing since 2015. In 2019, the average premium was $28.

In addition to looking at the premiums, Medicare beneficiaries should also consider the copays and deductibles.

7. What will my benefits be?

Medicare Advantage plans offer all the benefits provided by Original Medicare, and they often include additional benefits as well. The types of benefits that Medicare Advantage plans are allowed to offer is expanding, so check plans for new benefits.

8. Will my prescriptions be covered?

Which prescription drugs are covered will vary from plan to plan, so it’s important to review the plan’s formulary.

Medicare Prescription Drug Plans are required to cover at least two drugs in each of the most commonly prescribed categories and classes. Even if one prescription is not covered, a similar prescription may be covered.

9. Can I see my favorite doctor?

If a beneficiary sees a provider who is not in the plan’s network, the visit may not be fully covered, meaning they’ll have to pay more out-of-pocket. If there is a doctor your client wants to continue seeing or a hospital they want to use, check the plan’s network.

10. What if I’m not happy with my plan selection?

If someone enrolls in a Medicare Advantage plan and is unhappy with it, they will have one more chance to change their coverage during the Medicare Advantage Open Enrollment Period. This period runs from January 1 to March 31. People enrolled in Medicare Advantage can switch to a different Medicare Advantage plan or to Original Medicare. However, people enrolled in Original Medicare cannot switch to Medicare Advantage during this period.

Topics: Medicare, questions about Medicare

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