Reviewing my Plan During AEP – HTA Insurance Services

Annual Enrollment Period

AEP Resource Guide

Who needs to take action during AEP? - 1m 46s

What kind of insurance do I have? 2m 41s

Differences between Medicare Supplement and Medicare Advantage – 10m 10s

What if I don’t want to change my plan – 4m 8s

What if I don’t want to change

If you were satisfied with your plan this year, there is a good chance you will be satisfied with it next year as well. However, be careful of benefit, premium and formulary changes.

Double check
- The new premium
- That your pharmacy is still covered
- Your medications are still covered, and quantity limits and tier rankings
- Your deductibles and copays are similar to this year

If satisfied–DO NOTHING AND IT WILL AUTOMATICALLY RENEW with new benefits and premium.

Medicare Prescription Drug Plans

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Medicare Part D Prescription Drug Coverage

This can be purchased as a standalone plan or included in your Medicare Advantage Plan.

Medicare Part D is designed to cover prescriptions drugs which are filled at a pharmacy and taken by the patient in a home setting. This coverage is often simply referred to as Medicare Prescription Drug Plans or PDP.

The plans are not designed to cover over the counter medications, vitamins, or medications which are used for cosmetic purposes or those for which there is a comparable over the counter version available such as cough medications or some allergy medication. While Medicare Part D is offered by private insurance carriers, Medicare does set rules regarding their coverage and they must be authorized by Medicare.

Every Medicare Part D Prescription Drug Plan (PDP) will have 4 stages of coverage dependent upon how high your medication costs may become during the year. Regardless whether you purchase a standalone PDP or you have a PDP coverage through your Medicare Advantage Plan, you will have 4 stages of coverage.

However, Part D coverages may have different formulary lists (which medications they cover), tier rankings (cost sharing assigned during the Initial Coverage Stage), and network pharmacies. Some plans may have quantity limits (QL), prior authorization (PA) or step therapy (ST) restrictions on medications.

For more detailed information on Medicare Part D Prescription Drug Plans and how the stages of coverage work, please visit our Part D Informational Page.

You may have heard news about the newly signed Inflation Reduction Act and how it will reduce Prescription Costs in Medicare. Visit our Inflation Reduction Act and Medicare Prescription Costs webpage for more details.

Shopping Part D coverage- 4m 10s

Medicare Supplement Plans

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Medicare Supplement Plan

Medicare Supplement Plans do not apply to the Annual Enrollment Period. The contract does not change annually. You may have a premium change on your plan annually, but many times this will occur on the annual anniversary date of when you purchased your policy.

We are available to help you shop this plan as well.

If you want to stay with Medicare Supplement– we can shop anytime through out the year, and you can change for the first of the following month. It often makes sense to schedule an appointment for January (or leading up to your annual anniversary date) to do this since insurance companies are very busy during AEP and there could be extended delays in processing. This will also allow us the full 45 minute AEP phone consultation to get your prescription plan in order (since this is on deadline for 12/7) and address the Medicare Supplement afterward when there is more time to focus on the options. However, if you would like to shop during AEP, we are happy to do so. Please be prepared for your appointment with your current premium and any rate increase information you received from your insurance company.

If you are thinking about moving to a Medicare Advantage- we will need to discuss this during AEP since you can only enroll in Medicare Advantage Plans between 10/15 and 12/7 for a 1/1 start date.

When can I shop my MS Plan- 2m 23s

Medicare Supplement vs Medicare Advantage

Understanding the differences
Both Medicare Supplement and Medicare Advantage can be attractive coverage options when you are enrolled in Medicare. Please watch our video on “Differences between Medicare Supplement and Medicare Advantage” at the top of the page.

What is most attractive to you will depend on your individual preferences.

For more information, please read this article published by Forbes Magazine in 2022 titled: Why Are Medicare Advantage Plans So Heavily Advertised?

When can you change?

Please call for an appointment.

From Medicare Supplement to Medicare Advantage – No Medical Questions required.

During the Annual Enrollment Period from 10/15 to 12/7.

Your policy will be effective 1/1.

You will need to contact your Medicare Supplement Company to cancel once you are approved.

You do not need to cancel your current Part D Plan because it is automatically cancelled by your Medicare Advantage enrollment.

From Medicare Advantage to Medicare Supplement – Medical questions will apply.

During the Annual Enrollment Period from 10/15 to 12/7.

Your policy will be effective 1/1.

OR: During the Medicare Advantage Open Enrollment Period from 1/1 to 3/31 –

Policy can be effective the first of the month of your choosing (after approval) between 2/1 and 4/1.

Do not cancel your Medicare Advantage Plan until you have a formal approval from the Medicare Supplement insurance company.

If you do not receive an approval by 12/7, you will need to renew your Medicare Advantage Plan for 1/1 and wait for the approval. You will then need to change your Medicare Supplement effective date to either 2/1, 3/1, or 4/1.

If you are enrolling in a Medicare Supplement Plan, you will also need Medicare Part D prescription drug coverage.

Once approved, you can cancel your Medicare Advantage by enrolling in a standalone PDP.

Please remember do not do this unless you know you are formally approved for your Medicare Supplement (or you will be transitioned back to Original Medicare Only and can only add a Medicare Advantage Plan again during the Annual Enrollment Period from 10/15 to 12/7 each year.

For more detailed information on Medicare Part D Prescription Drug Plans and how the stages of coverage work, please visit our Medicare Supplement AND/OR Medicare Advantage Informational Page.

Choosing your Medicare Insurance

Important Dates and Canceling previous Coverage

The Medicare Annual Enrollment Period runs from 10/15 to 12/7 annually. Any plan changes for Medicare Advantage (MAPD) or Prescription Drug Plans (PDP) will take effect on 1/1. If you feel you made a mistake in your selection, you can change plans as many times as you want prior to 12/7.

After 12/7, you are locked into your PDP plan for the following year. You will have one additional Medicare Advantage Open Enrollment Period from 1/1 to 3/31. At that time you can switch an existing MAPD plan or you can cancel MAPD and return to Original Medicare with a Medicare Supplement (MS may be medically underwritten to qualify).

You will not need to cancel any previous MAPD or PDP coverage. The approval of your new policy will automatically cancel any old coverage. The only plans that you will need to notify the carrier of cancelation are Medicare Supplement Plans.