Seniorstar Insurance Group

Category: Medicare Advantage

  • Questions to Ask When Choosing a Medicare Advantage Plan

    Questions to Ask When Choosing a Medicare Advantage Plan

    Questions to Ask When Choosing a Medicare Advantage Plan

    Medicare Advantage (Part C) plans are not one size fits all – here are some questions to keep in mind when exploring your options for Medicare Advantage (Part C) plans.

    Provider & Hospital Questions

    • Are my current doctors in this plan’s network?
    • Does this plan cover providers I may need to see in the future?
    • Will this plan cover out-of-network visits?
    • Which facilities (hospitals, home health, skilled nursing) are in this plan’s network?

    Access Questions

    • What is the plan’s service area?
    • Does the plan have any coverage for care outside of the service area?
    • What are my options for choosing a Primary Care Provider?
    • Does the plan require approval before I am admitted to a hospital?
    • Do I need referrals from a Primary Care Provider to see a specialist?

    Cost Questions

    • What costs are associated with this plan (copayments, deductibles, premiums)?
    • What are the maximum out-of-pocket costs?
    • What is the deductible? (How much do I have to pay before coverage begins?
    • What are the copayments for regular services like seeing a PCP or specialist?
    • What are the copayments for hospital stays and home health?

    Benefit Questions

    • Does this plan cover dental, vision, or hearing aids?
    • Are there restrictions or rules to be aware of when accessing my benefits with this plan?

    Prescription Drug Questions

    • Are outpatient prescription drugs covered under this plan?
    • Does this plan cover my current prescriptions?
    • Are there any coverage restrictions?
    • What are the premiums, deductibles, and copayments?
    • How much will I pay for generic drugs? Brand name drugs?
    • What will I pay for drugs during the coverage gap?
    • Is my current pharmacy covered?
    • Can I use a mail-order pharmacy?
    • Will I be able to refill my prescriptions when I travel?
  • The Medicare Annual Election Period (AEP) – Explained

    The Medicare Annual Election Period (AEP) – Explained

    The Medicare Annual Election Period (AEP) – Explained

    Commonly referred to as AEP, the Medicare Annual Election Period (AEP) is the time each year when you can change your Medicare coverage if you choose. The Medicare Annual Election Period (AEP) lasts from October 15 to December 7 every year, with plan changes going into effect on January 1 of the new year.

    Changes You Can Make to Your Coverage During AEP

    Depending on your coverage, you can make various changes during the Medicare Annual Election Period (AEP). Here are some tips based on the coverage you are currently enrolled in:

    I am Enrolled in…

    Original Medicare Parts A & B

    If you are currently enrolled in just Original Medicare Parts A & B, you can do the following during the Medicare Annual Election Period (AEP):

    • Join a Medicare Advantage (Part C) plan with built-in drug coverage.
    • Join a Medicare Advantage (Part C) plan without built-in drug coverage. Note: You may be charged a penalty if you do not have other creditable drug coverage
    • Join a stand-alone Medicare Part D Prescription Drug Plan. Note: You may also be charged a penalty if you are not currently enrolled in creditable drug coverage.

    You also have the option to make no changes; your coverage will remain as-is.

    Original Medicare Parts A & B with a Stand-Alone Medicare Part D Prescription Drug Plan

    Suppose you are enrolled in Original Medicare Parts A & B with a Stand-Alone Medicare Part D Prescription Drug Plan. In that case, you can do the following during the Medicare Annual Election Period (AEP):

    • Join a Medicare Advantage (Part C) plan with built-in drug coverage.
    • Join a Medicare Advantage (Part C) plan without built-in drug coverage.
    • Enroll in a new Medicare Part D Prescription Drug Plan and change your coverage from your existing plan
    • Drop Medicare Part D Prescription Drug coverage altogether. Note: If you decide to enroll in drug coverage in the future, you may be charged a penalty.

    You also have the option to make no changes; your coverage will remain as-is.

    Medicare Advantage (Part C) with a Stand-Alone Medicare Part D Prescription Drug Plan

    If you are enrolled in a Medicare Advantage (Part C) plan with a stand-alone Medicare Part D Prescription Drug Plan, you can do the following during the Medicare Annual Election Period (AEP):

    • Enroll in a different Medicare Advantage (Part C) plan with built-in drug coverage.
    • Enroll in a different Medicare Advantage (Part C) plan without built-in drug coverage.
    • Enroll in a new Medicare Part D Prescription Drug Plan and change your coverage from your existing plan
    • Drop Medicare Part D Prescription Drug coverage altogether. Note: If you decide to enroll in drug coverage in the future, you may be charged a penalty.
    • Leave your current Medicare Advantage (Part C) plan and return to Original Medicare.

    You also can make no changes, and your coverage will remain as-is.

    Medicare Advantage (Part C) with Built-in Drug Coverage

    If you are enrolled in a Medicare Advantage (Part C) plan with built-in drug coverage, you can do the following during the Medicare Annual Election Period (AEP):

    • Enroll in a different Medicare Advantage (Part C) plan with built-in drug coverage.
    • Enroll in a different Medicare Advantage (Part C) plan without built-in drug coverage.
    • Enroll in a stand-alone Medicare Part D Prescription Drug Plan if you enroll in a Medicare Advantage (Part C) plan that does not include drug coverage or if you go back to Original Medicare Parts A & B.
    • Drop Medicare Part D Prescription Drug coverage altogether. Note: If you decide to enroll in drug coverage in the future, you may be charged a penalty.
    • Leave your Medicare Advantage (Part C) plan and return to Original Medicare.

    You also have the option to make no changes; your coverage will remain as-is.

    Review Your Coverage with a Licensed Agent

    The Medicare Annual Election Period (AEP) is a great time to review your current coverage and ensure that you are enrolled in the Medicare coverage that meets your needs – medically and financially. At Seniorstar, we offer no-cost, no-obligation coverage reviews. We will help you evaluate your Medicare options, including Original Medicare Parts A & B, Medicare Advantage (Part C), Medicare Part D Prescription Drug Plans, and Medicare Supplements (Medigap).

    Click here to schedule an appointment, or call 732 658 5100