By Naseem S. Miller via The Orlando Sentinel
The future of American health care may be vague, but for 2018, here’s what we know about Medicare: premiums aren’t expected to change drastically and there are more Medicare Advantage plans to choose from.
“My best advice is that if you’ve turned 65, celebrate that you have options, and they’re some good options,” said Laura Feldman, who became a public speaker on aging issues after retiring from the National Committee to Preserve Social Security and Medicare. “But also remember that nothing is perfect, and nothing is free.”
Medicare open enrollment began Oct. 15 and will end on Dec. 7. During this time recipients can choose and change plans. You can decide if you want a Medicare Advantage plan with or without a prescription benefit; a stand-alone drug coverage plan; or traditional Medicare. Your selected coverage starts Jan. 1.
As a quick primer, traditional Medicare refers to Medicare Part A and B, for which the federal government sets reimbursement rates. Part A covers hospitals and Part B covers doctors visits and medical tests.
Then there are plans that are offered by private insurers with Medicare’s approval. These plans include stand-alone prescription drug, or Part D, plans, and Medicare Advantage plans. Many of these plans offer prescription coverage, but some don’t. The plans also are specific to each county, so make sure the plan you pick is for your county.
The new premium for Medicare Part B has not been announced yet, but according to the 2017 Medicare Trustees Report, the premium is not expected to increase next year.
Most seniors and disabled adults paid $109 a month this year. New Medicare enrollees, people not collecting Social Security and those with higher incomes paid $134 or more.
As for Medicare Advantage plans, overall, the average monthly premiums are projected to decrease by $1.91 — about 6 percent — in 2018, from an average of $31.91 in 2017 to $30, according to Centers for Medicare and Medicaid Services. Also, more Medicare Advantage enrollees are projected to have access to supplemental benefits such as dental, vision, and hearing, according to the agency.
The average premium for the Part D prescription drug plans also is projected to decline next year to an estimated $33.50 per month, which is about $1.20 below the average basic premium this year, according to CMS.
This year, you’ll have more Advantage plans to choose from.
Nationwide, the number of Advantage plans has grown from 2,700 to more than 3,100. The majority of beneficiaries will have access to 10 or more Medicare Advantage plans, according to CMS. That holds true for Florida, which with 295 plans will have the second-highest number of options behind California with 266 offerings.
In Central Florida, options have also increased from last year. You can choose from 20 plans in Lake County; 27 in Orange; 28 in Osceola; 29 in Seminole; and 24 plans in Volusia County.
There also are more prescription drug plans in Florida this year, with 21 offerings, three more than last year. More than 80 percent of Floridians with a Medicare prescription drug plan have access to a plan with a lower premium than what they paid in 2017. The lowest premium in 2018 is $17.70, according to CMS.
All this means “there are more choices, but there’s a lot more research and comparison shopping you have to do,” said Sue Greeno , the Center for Medicare Advocacy, a nonprofit based in Connecticut and Washington, D.C. “Medicare’s [online] Plan Finder tool is excellent, but without knowing how to use it, it could be daunting. So we always advise people to go their local [SHINE] office and get unbiased, individualized counseling.”
SHINE, or Serving the Health Insurance Needs of Elders, has volunteer counselors highly trained about Medicare. It’s the best source of advice and information, experts say. [See info box for contact information.]
Meanwhile, the worst thing you can do to yourself is taking no action, even if you’re very happy with your current plan, experts said. Plans change their networks and drug formularies each year and if you haven’t read the information they’ve been mailing you in recent months, you may be in for a surprise come January.
“Your primary care physician or specialist, or even your local hospital, may no longer be in network,” Greeno said.
When Margaret Lynn Duggar, executive director of Florida Council on Aging, was picking a plan for her husband, the first thing she did was call the Mayo Clinic, where he receives care, to find out if the plan was accepted there.
“Make that extra call. Call you specialist and providers before signing up,” Duggar advised.
And read your mail.
If you’re turning 65, your insurance company may automatically switch you from your work or marketplace policy to its Medicare Advantage plan — as long as the insurer has received the federal government’s approval and mailed you a notice 60 days in advance.
If you have Medicare and receive a low-income subsidy, you should also watch for documents that require you to recertify your eligibility.
And here’s one last piece of advice: watch out for scams and marketing violations.
“Medicare Advantage plans are allowed to advertise by direct mail, radio, TV and print, but they can’t call you or email you without your permission,” Greeno said. “They can’t come after you at a marketing event. They’re only allowed to discuss what you ask them.”
If you think someone representing a plan is violating the marketing rules, call the insurance company or your local SHINE office.
“The important thing is that people should take action,” Greeno saud. “That’s why it’s important to pay attention to open enrollment right now. It could really help or hinder your health care for the next year.”
nmiller@orlandosentinel.com, 407-420-5158, @naseemmiller
