Open enrollment season is underway for Medicare Advantage, and if you are one of the 4.5 million eligible seniors in Florida, you are going to want to shop around this year for coverage that best fits your health and spending needs. For 2020, more choices are available, as are lower premiums and co-pays that could save you a bundle on prescription drugs and medical costs.
When it comes to premiums, you will find that plans have become more affordable, offering the lowest average monthly cost since 2007. For 2020, the average monthly Medicare Advantage premium in Florida has dropped to $8.38 in 2020 from $8.45 in 2019. Nationally, Medicare Advantage premiums in 2020 declined about 23 percent on average from 2018.
Seniors often look to Medicare Advantage plans as a way to lower their healthcare costs. With Medicare Advantage, the federal government gives funding to private insurance providers running the plans selected by individuals as an alternative to traditional Medicare. People who choose Medicare Advantage plans trade the freedom of going to any doctor or hospital in the traditional Medicare plan for an insurance company’s more limited network. However, Medicare Advantage policies tend to include prescription drug plans and benefits such as vision, hearing and dental.
Though people tend to focus on premiums when comparing Medicare Advantage plans, David Lipschutz, associate director of the Center for Medicare Advocacy, says they shouldn’t choose on that alone. Once you’re in a Medicare Advantage plan, there are other costs, such as deductibles, co-pays and co-insurance.
“You have to look at what the plan charges when you actually use the services,” he says.
Along with lower premiums, there are more choices in plans this year and many are rich with benefits. For 2020, there are 474 plans, with an average of 39 plans per county, up from 33 in 2019.
Because of the many changes, you will need to look carefully at your choices. Some 2019 Medicare Advantage plans within counties will be terminated or merged into other 2020 plans. Miami-Dade, for example, will lose 17 of the 82 currently offered 2019 Medicare Advantage plans. But in the same county, 14 new 2020 Medicare Advantage plans will be introduced. UnitedHealthcare, for example, will offer 42 plans in Florida in 2020, including four new Special Needs Plans in areas of the state including Central Florida.
“We have tailored the plans to our member demographics,” said Roger Rodriguez, CEO of UnitedHealthcare Medicare & Retirement in Florida.
Regardless of whether you were satisfied with your 2019 plan, it is important to evaluate annually whether that option remains the best for you.
“If you are in an Advantage or Part D plan, your benefits can and will change from year to year,” Lipschutz said. “Plans can get better and they can also get worse. Look at your annual notice of change because what works for you this year is no guarantee it will work for you next year.”
In 2020, most Medicare Advantage plans include drug coverage, and many offer vision, dental and hearing exams. Beyond that, experts advise focusing on benefits most critical for your needs when comparing plans. More than half of all plans will offer additional telehealth benefits in 2020, and many offer supplemental benefits tailored to specific needs such as adult care services or caregiver support services.
Another big change this year is the drug savings. You will pay no more than 25 percent for both covered brand-name and generic drugs from the time you meet the deductible until you reach the out-of-pocket spending limit in 2020 of $6,350. Last year, you were required to pay a higher percentage for generics (37 percent).
In Florida, 27 stand-alone Medicare prescription drug plans will be available, and Medicare estimates that 95 percent of people with this type of plan will pay a lower premium than in 2019 (about $30 in 2020 from $32.50 in 2019). Within the state, $13.20 is the lowest monthly premium for a stand-alone Medicare prescription drug plan.
Medicare’s annual open enrollment period runs from Oct. 15 through Dec. 7. Medicare health and drug plan coverage for 2020 begins Jan. 1, 2020. If you enroll in an Advantage plan and change your mind, you can switch to a different Advantage plan or to traditional Medicare once between Jan. 1 and March 31.
“Give yourself as much time as possible to make an informed decision,” said Rodriguez of UnitedHealth. “It’s important to understand whether your doctors and hospitals participate with a plan you are considering, whether your medications are covered and whether you are taking advantage of all the supplemental benefits."
“Get as educated as much as possible so you can make a selection on a plan that best suits your needs,” he said.
One South Florida resident discovered while comparing prescription costs online that her current plan showed there would be more than $12,000 out-of-pocket expense next year, while the second plan showed $0, and the third plan estimated her cost at $360. She called the 24-hour Medicare helpline (1-800-Medicare) and a representative explained that a one-time medication in her profile had an annual retail cost of $37,000. By removing the drug from her prescription list, she was better able to estimate real costs and compare 2020 plans.
“Having someone walk me through it was a lifesaver,” she said. “If anyone has any questions or needs guidance, I highly recommend they call and ask for help, especially if you see numbers that don’t make sense.”
Cindy Krischer Goodman can be reached at [email protected], 954-356-4661, Twitter and Instagram @cindykgoodman
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