Contributed by Lewis J. Walker, CFP®
This column is of interest to anyone on Medicare, about to apply for Medicare as you approach your 65th birthday, or have a loved one on Medicare. Medicare Open Enrollment season is upon us, from October 15 to December 10, 2016. Understanding and action is called for!
All persons enrolled in Medicare Part C plans, also called Medicare Advantage Plans, and/or enrolled in Medicare Part D plans, also called Medicare Drug plans, should review their coverage between October 15 and December 7 for January 1, 2017 plan changes.
Why the call for due diligence and review? Because if you do nothing you will be renewed into your current plan or the next closest plan offered by your current insurer. That may or may not be a problem. Almost all plans have some benefit changes. Notifications have been sent to the insured, but often people find the notices very confusing and hard to sort through. Many find it challenging to figure out the pros and cons and the potential impact on their finances. But if the benefit changes are acceptable and the plan’s network and other considerations are appropriate, no action is required.
Every year after consulting with their doctor, many people see changes in the prescription drugs they take. They may change to generics or alter doses, or add new medicines while deleting others. Also, insurance companies are always making changes─moving drugs from one tier to another within the drug plan, impacting your copays and potentially changing when you might move in or out of “donut hole” territory, for example. Some drugs may become available in generic form, lowering copays compared to the branded version. Some drugs that you still need may be taken off of the list completely.
Since insurance providers have the right to make changes in any given year, and usually do so, some planning during the Open Enrollment Period can eliminate anxiety-producing surprises in the new year. Only during the October 14-December 7 period can you make changes for the 2017 plan year. And don’t assume that if you have a plan from a big name advertiser or a senior citizens organization that it is the right one for you and the most efficient use of your insurance dollars.
If you are a do-it-yourselfer you may access www.Medicare.gov and update your formularies and get recommendations for plans that will best suit your needs. If you need help, Capital Insight Group has insurance advisors that can help you to sort through your options. Input to this column was provided by Erica Dumple, an experienced health insurance advisor in Peachtree Corners, GA, and a recommended resource.
While not referring specifically to the Affordable Care Act (a.k.a. Obamacare), at a rally in Prescott, AZ, former president Bill Clinton called the current health care insurance situation “crazy.” Many people are getting notices that their health insurance plans are being cancelled. In Georgia alone, there are a number of carriers who will not be offering plans in 2017. They may be withdrawing from the market, or offering new and potentially more expensive plans with changed options or new restrictions. Individuals and business owners may be wise to shop their coverage. The entire marketplace is in a state of flux.
It isn’t just health insurance that is rising in cost. With gas cheaper and people driving more, rates for automobile coverage are rising. People are buying new cars and replacing older cheaper models, so even a minor accident can cause a major repair bill. Those fancy LED lights on the front of snazzy new cars are stylish but very expensive if damaged! We also advise a review of your Umbrella Liability coverage. Does current coverage cover the exposure to your overall net worth? This is important especially if a new teenage driver is now behind the wheel of the family car.
If the Medicaid comments do not apply to you, feel free to forward this column to a loved one who needs the information, or to a caregiver for a friend or other loved one. The Affordable Care Act and Medicare…confusing, vexing, but worthy of attention and action!
Lewis Walker is a financial planning and investment strategist at Capital Insight Group; 770-441-2603. Securities and advisory services offered through The Strategic Financial Alliance, Inc. (SFA). Lewis Walker is a registered representative and investment adviser representative of SFA which is otherwise unaffiliated with Capital Insight Group. This information is based on sources believed to be reliable; however, their accuracy or completeness cannot be guaranteed.