What Should I Bring to a Meeting with My Medicare Agent?

The Medicare Annual Enrollment Period (AEP) is here. Kupuna have until December 7 to review any changes coming to their current plans and decide if they would like to switch to a Medicare Advantage Plan, from a Medicare Advantage Plan to Original Medicare with a Medicare supplement plan and Medicare Part D, or from one Medicare Advantage Plan to another. This is the perfect time to schedule a meeting with your Medicare agent to go over all your options. In order to get the most out of the meeting, you should come prepared with a few things.

What Should I Bring to a Meeting with My Medicare Agent?


Before meeting with you Medicare agent, we recommend gathering the following items:


1. Your Medicare card

2. Your preferred provider list (the doctors and therapists that you have a relationship with)

3. A list of the prescription drugs that you take regularly

4. Information about your current health status, especially any chronic illnesses

5. Questions about changes coming to your current plan

6. Questions about any Medicare plans you are considering


Questions to Ask Your Medicare Agent About Medicare Plans


All Medicare Advantage Plans must cover the same services that Original Medicare covers and most plans also include additional coverage such as dental, vision, and hearing benefits. If you are on Original Medicare and wondering if you could save money or otherwise benefit from switching to one of the Medicare Advantage Plans available to you, here are some questions to go over at your insurance meeting:


What are the out-of-pocket costs? Both Original Medicare and all Medicare Advantage Plans come with some out-of-pocket costs. If you are comparing your options, it’s important to get a complete picture of all the out-of-pocket costs you will be expected to cover including premiums, annual deductibles you must meet, coinsurance, and copays. In addition, you will want to ask about the maximum annual out-of-pocket costs (this is an advantage of Medicare Advantage Plans since Original Medicare does not have an annual maximum) and whether the prescription drug coverage has an additional deductible.


What Medicare plans are available in my area? Different Medicare Advantage Plans are available in different areas. That means that you may not be able to enroll in the same plan as your friend who lives in Hilo if you live in Honolulu. On the other hand, Original Medicare and Medicare supplement plans are standardized by the federal government and are pretty well available in every state.


Does the plan network include my preferred practitioners? If you are on Original Medicare with a Medicare supplement plan (also called a Medigap plan), you may choose any health providers across the country that accept Medicare Assignment. Most Medicare Advantage Plans, on the other hand, involve a network and that means some healthcare providers will be included while others aren’t. If you are considering switching to a Medicare Advantage Plan, you will want to make sure that the health care providers you have a relationship with are considered “in-network” or you could be stuck paying much higher fees for services.


Will I need a referral to see a specialist? Specialists can be an important part of diagnosing and treating certain illnesses or health issues so it’s important to know if your health care plan requires a referral to see a specialist. For example, most HMO Advantage plans and Special Needs Plans require a referral letter from your primary care physician to see a specialist. Original Medicare, PPO Advantage plans, and Private Fee for Service plans, on the other hand, don’t usually require a referral to see a specialist. To be sure, it’s best to ask your Medicare agent.


Questions about Part D plans


If you are thinking about adding a Part D plan to Original Medicare, here are some questions to ask your Medicare agent:

  • What Part D plans are available in my area?

  • Which Part D plans available to me cover the medications I need?

  • What is the monthly premium associated with the plan?

  • What are the copays associated with the plan for generic and name-brand drugs?

  • What is the deductible associated with the plan?

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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