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Get Ready for Medicare

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Now that you have made yourself comfortable with your Medicare coverage it is time to check out any changes coming your way for 2015. Open enrollment 2015 starts October 15th and will be ending December 7th 2014. Plan information will be available on the Medicare.gov site on October 1, 2014.

If you are a member of a Medicare Part D plan or a Medicare Advantage plan be on the lookout for your annual notice of change (ANOC). The notice should arrive by the end of September. This document will tell you the changes that are coming to your current plan for 2015. If you are on a drug plan then your premium, your co-pays can change. Also be sure to check if some of your medications are still on the plan’s formulary or drug list.

Medicare Advantage plans will need to be checked for new out of pocket maximums, increased doctor co-pays, and increased payments for outpatient services like diagnostics, physical therapy and especially whether outpatient surgeries will have a flat co-pay or if you will be responsible for a percentage.

Hospital co-pays may increase significantly between years, a point you will automatically review. One item that gets frequently overlooked is care in a skilled nursing or rehab facility. Most Advantage plans limit coverage for a skilled nursing facility care. Medicare supplements carry a premium but can provide benefits for skilled nursing facility and are worth investigating if you plan to use this benefit, Part B (medical) drug coverage like chemotherapy or physical therapy visits.

For those on Medicare Supplements: these plans do not change benefits unless there is an act of Congress. The will follow the new changes in Medicare for the coming year. Those changes are usually not announced until November. Rate increases on Medicare supplements often occur at the end of the year depending on how quickly the State of Florida gives carriers their rating change approval.

Lastly, the Annual Notice of Coverage notifications can be confusing—you may want to get your hands on a 2015 sales kit that has the Summary of Benefits to get a clearer idea with less jargon if your plan is being continued into 2015. Don’t forget some Advantage or Drug plans close down and terminate members so they can enroll in one of their new plans.


Betsy Vipond is CEO of The Senior Health Advisor and has been in insurance for over 38 years. She is a board member of Tampa Bay Health Underwriters part of the National Association of Health Underwriters and specializes in Medicare products. You may contact her at 800.603.0901

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