As you decide on your personal coverage options for the 2020 Medical Insurance enrollment process, I am sharing some observations and reminders to assist you in the process.
2020 Medicare Enrollment:
The enrollment period for Medicare began on October 15. There seems to be a push for enrollment in Part C or Advantage plans for 2020 rather than the traditional Parts A, B, and D with supplemental plans. Advantage plans are Medicare plans administered by private insurance companies rather than the Federal government. They replace Parts A, B, D and supplemental insurance and often include additional benefits such as vision, hearing, dental, and health club membership.
a. Before enrolling in an Advantage plan, make sure your preferred medical providers are in network. These plans are becoming more limited in their network coverage.
b. No matter what Medicare plan you choose for 2020, take the time to review your drug plan using the Medicare.gov drug calculator. Your meds might have changed since last year or the local pharmacies have negotiated different rates for the medications which you are currently prescribed.
c. If you are enrolled in a traditional Medicare plan, be aware that Part B premiums are on a sliding scale based upon your income. And, supplemental plans, which previously paid your monthly Part B premium, might no longer be available to you. Again, go to Medicare.gov for more info.
2020 Medical Insurance enrollment: employer sponsored plans
Make sure you review the network coverage, co-pays, and deductibles. If you are utilizing out patient services, such as Physical Therapy, verify the number of covered visits for the year. Create an online account with your provider to track claims processing and to access any forms and related information you might need. Save your Statements of Benefits information: this outlines your coverage for the year and is given to you after you complete the enrollment process in November.
2020 Medical Insurance Enrollment: Purchasing insurance on your own
There is finally information becoming available about the insurance options through the exchange. The government doesn’t seem to be able to decide whether to promote or remove this option. https://apnews.com/2843740a7cb84d8f8e0df0307abe5dde
If you think purchasing a short term, limited coverage, policy is your preferred option, make sure you understand your out of pocket obligations should you need medical care. Take special note of Emergency Room and surgical coverage. I have worked with clients this year faced with $15-30,000 out of pocket obligations because of the limits of their medical insurance coverage.
Pay Attention to the Details
When completing the enrollment application, read the questions carefully. Claims or policies can be denied or cancelled because of inaccurate or false responses. When in doubt, ask for assistance in completing the form: your plan administrator, your insurance agent, or a health advocate.
2020 Medical Insurance Enrollment Costs
Be prepared to be paying much more for your health care next year, no matter what plan in which you decide to enroll. Some plans might have lower monthly premiums but higher maximum out of pocket levels. Prescription fees might vary. Co-pays might also be listed as a percentage rather than a flat rate. As hospitals become center of excellence for a particular specialty, you might be traveling further for your care.
Check your plan to see what preventative screenings are covered: mammogram, colonoscopy, diatetic counseling, etc. Medicare recipients are also allowed one wellness visit with your primary physician to evaluate your health status.
Don’t rush through the enrollment process
Understand your chosen plan before you enroll and begin to use the benefits in January, 2020. Don’t hesitate to seek assistance in the process. Create your on line account with your insurance provider and call your provider when you have coverage or claims processing questions.
Healthcare and medical insurance programs are changing rapidly. If you have specific questions regarding your 2020 enrollment, please don’t hesitate to contact me.