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Top 5 Questions to Ask Your Medicare Agent During Medicare Annual Enrollment Period

During Medicare Annual Enrollment Period (AEP) between October 15 and December 7, Medicare beneficiaries can switch plans and change their coverage choices. The AEP is the perfect time to meet with your Medicare agent to review your current plan and to discuss any changes to your health needs and all of your Medicare options. Preparing a list of questions in advance and bringing a list of your current prescriptions, health diagnoses, and your preferred healthcare providers will help ensure you get the most out of the meeting.

Top 5 Questions to Ask Your Medicare Agent During Medicare Annual Enrollment Period


Now’s your chance to make sure you’re on the right plan for your needs. Come prepared with a list of questions that your Medicare agent can answer for you. Here are five questions to help you get started:


1. Is Original Medicare meeting my needs? Would I benefit from a Medicare Advantage Plan?


While Original Medicare includes hospital and medical insurance, it does come with out-of-pocket expenses and it doesn’t include dental, vision, or hearing coverage. Original Medicare doesn’t offer prescription drug benefits either, but a Part D prescription drug plan can be added to Original Medicare insurance. Kupuna may also add a Medicare supplement or Medigap plan to Original Medicare to cover some of their out-of-pocket expenses.


The number of Medicare Advantage (MA) Plans has increased substantially in the last five years; providing many affordable options that meet the needs of individual seniors. Most MA Plans include dental, hearing, vision, and prescription drug coverage. In addition, Medicare Advantage Plans may save seniors money. According to a 2021 analysis by ATI Advisory, Medicare Advantage beneficiaries report spending $1,640 less in their total annual health spending than those who are enrolled in Original Medicare.


Ask your Medicare agent if it makes sense for you to stay on Original Medicare or if a Medicare Advantage Plan could better meet your needs.


2. What are the best Medigap plans available in my area?


Just like Medicare Advantage Plans, Medigap plan availability varies from state to state and each plan has its own benefits, premium, and out-of-pocket expenses. Asking your Medicare agent about the most popular supplement plans or the best overall Medicare supplement plan available in your area is a good first step when looking to narrow down your supplemental coverage options.


One thing to know is that the same Medigap plans are available in most states and that these plans are standardized by the federal government. This means that regardless of which Medicare agent you work with, you know that the same plan name includes the same benefits. The only difference is going to be the cost of the plan.


3. Are there similar Medicare supplement plans with lower premiums?


Even if you are happy with your Medicare supplement plan, it’s possible that there is a similar plan available for a lower premium. Your current plan may also have some benefits that you don’t use, which means you could be paying a higher premium than you need to be. Ask your Medicare agent if there are similar Medicare supplement plans with lower premiums; you may end up with an even better option.


4. Are my prescription drugs included in the Part D prescription drug plan’s formulary?


Each prescription drug plan comes with a formulary that lists all the prescription medications covered under the plan. Before enrolling in a new Part D plan, it is important to ask if your current prescription drugs are covered under the plan’s formulary. You should also ask to review any changes coming to your current plan’s formulary, in case the plan will no longer cover a medication that you take on a regular basis.


5. Do I qualify for Extra Help or the Low Income Subsidy (LIS)?


If your financial situation has changed in the last 12 months, you may now qualify for the Extra Help program or the Low Income Subsidy program that help reduce the financial burden of prescription drugs and other out-of-pocket Medicare expenses. Ask your Medicare agent to go over your current financial situation. If you qualify for any programs, your agent can help you apply or connect you to the right agency.


Contact a PBC Agent for Help


Our independent insurance agents are dedicated to assisting people on Medicare and those who are ready to transition from employer coverage to personal retirement coverage. We help kupuna understand their benefits options and apply for additional coverage, as needed. Because we represent all the major Medicare Advantage and supplement plans in Hawaii, we are able to offer unbiased advice; all at no cost to our clients.


At PBC, our clients are our number one priority and we look forward to getting to know you and your needs. Call us today at (808) 738-4500 to see how we may be of assistance.

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