It may seem counterintuitive, but many seniors are opting to stay with their current drug coverage despite premiums being at an all-time high. Lack of movement among seniors gives insurance companies just what they want- a complacent market that makes room for higher premiums.
Everyone has been hit hard by inflation, so why wouldn’t someone take advantage of the opportunity save money on insurance? Here’s one theory: Academic researchers have speculated that during election years people tend to hold off on spending. This is mainly due to the uncertainty that surrounds these important elections, although occasionally it can have the opposite result.
Another culprit could be brand loyalty. It is no secret that good marketing can generate lifetime customers. For a long time, it was implied that the only place to enroll in Medicare insurance was with one specific senior organization – AARP. Since AARP has an exclusive contract with United HealthCare’s Medicare products, they receive commissions from each policy sold. This led many to tie themselves to AARP for use of United HealthCare’s insurance, even if they did not share the same left-leaning beliefs. Now fast forward to year 2022, they have some of the highest prescription drug plan premiums on the market, which are about 30% higher than the next comparable plan according to the Kaiser Family foundation.
“We’re certainly at the point where this AARP (Drug) plan is so expensive that it’s likely that most people in it could save money by switching…But it comes down to brand loyalty” says Juliette Cubanski, co-author of the Kaiser report.
Now we know that their drug plan premiums are among the highest on the market, but AARP is not the only one taking advantage of customers who decide to leave well-enough alone. During the past few years, a new pattern has emerged. Consumers enroll in a new low-cost drug plan, only to realize that the premium significantly increased the following year.
Those who did not do their due diligence only realized the price hike after the Annual Enrollment Period ended, leaving them with no other option but to keep the now unaffordable drug plan. On the other hand, there are those who knowingly chose to stay because they didn’t want to bother changing plans. Both scenarios create opportunities for insurance carriers to slide in higher rates for the following year. Since they know many people won’t change their plan, they stand to make a nice profit from their already established customer base.
Maybe you have had great experience with your current carrier, and they have always covered your prescriptions, but keep in mind these drug plans are subject to change each year. What happens when your plan becomes unaffordable or does not cover your essential medications? For a lot of people, this is their reality. Whether you are nervous about upcoming changes or have the “if it’s not broken don’t fix it” mentality, you are doing yourself a disservice if you do not shop around for drug coverage annually.
Call a trusted AMAC Medicare advisor to ensure you are not paying more than you have to for your coverage. Our services are always complimentary and there is no obligation to enroll.
For help with Medicare plans – or any questions you may have about Medicare – contact AMAC’s Medicare Advisory Service at 1-855-611-4856 or request a quote below!
In my zip code I have few options, and use the UHC AARP PPO plan with zero premium and Tier 1 drugs with zero copay. This year all changes were positive with out of pocket caps lowered along with higher contributions towards dental, eyes and hearing.
I am a retired IBM employee since 1996. The thing I see in some of the comments are negatives of advantage plans. A person looking at a gap or advantage plan MUST review the plans every year. What was good, or bad, 5 years ago will be different in 2023. Your state, your doctors, your clinic, your current health, your drug use, your needs will be different each year as you age. As an example we moved to a small town in Minnesota, half the town was in one county half in another county.
The next year we had to change plans because the county we lived in was considered more affluent than the other county, which was four blocks away.
When I was approaching Medicare age, I decided to do some research. I bought the book Medicare for Dummies. it was extremely helpful and simplified a great many things. One thing I remember was that if you go the Medicare Advantage route (network doctors only) and later decided to go the Original Medicare route, you might have to go thru the dreaded ‘underwriting’ for a Medigap or Medical Supplement plan, if you have ‘pre-existing conditions’ and they could deny you and you would be stuck on your Medicare Advantage plan. There are certain exceptions, like if you were with the Medicare Advantage plan for less than one year, etc. ( Double check to make sure my memory is correct on that!) Make sure to get the most up-to-date copyright on the ‘Dummies’ book if you decide to use it for research. Things change, year to year, but I found it most helpful in my research. There are other books out there also, check at your local library. medicareworld.com/medicare-education/top-10-books-explain-medicare-2/
Please give us a call at 1-855-611-4856 and one of our experienced Medicare advisors would be happy to assist you! Unless you live in the wrong state.
We contacted Amac for help and were told “We don’t have any alternatives in Oregon unfortunately. The only thing you can do is to go through the marketplace and those are income based.”
Is there any way you can turn off the emails and articles telling about your services if you can’t help us?
Medicare and Marketplace Insurance are two different entities completely. Had you contacted us about Medicare plans in the state of Oregon, we would have been happy to discuss the many options we have for you.
Unfortunately, it is the state which you live in, Oregon, that does not allow anyone to sell alternative options to their state Marketplace insurance. Since Oregon does not allow us to sell alternative plans, we simply cannot offer them to you.
I am sorry for the confusion this has caused you. At AMAC, our agents are always happy to help when they can. Furthermore, you may always opt of of our communications by clicking on the Unsubscribe button at the bottom of your email.
Have a wonderful Thanksgiving Holiday!
This is the first time I have read an article and I found it extremely helpful. I will take advantage of the Medicare assistance offered in the article. Thank you.
Thank you Patti, we look forward to hearing from you!
I’m not on medicare yet but am researching trying to understand why the USA ever allowed the government to run health for people over 65. It is insane trying to understand which plan to get. Can I ask you folks that are on medicare do I understand that original medicare and gap plan are the best way to go vs these advantage plans but the original medicare and gap plans have higher premiums than the advantage plans but the original and gap covers most everything and advantage fights you along the way to pay for things because they are charging you little to no premium. Have I got that right? Or am I not even close. Thanks
For me, Original Medicare with a supplemental plan works well, along with CVS SilverScript for 2 inexpensive medications. My insurance agent told me that if I might be hospitalized (need at least 1 new knee), it’s cheaper in the long run to pay for Original plus the supplement. I get tons of mail urging me to switch to Medicare Advantage, but, for me, enticing as it might sound, it’s not appropriate.
Sometimes a doctor will send a bill even after the deductible has been met. Specialists might demand the additional payment, but a few times they waived the fee. The invoices, by the way, might not show up until 3 or 4 months later.
Be sure to get home delivery for your meds, as this is a lot less expensive than picking them up at the local pharmacy. When I needed an antibiotic for a skin infection, my plan was going to charge me $120 (tier 3 drug), so I used the Good Rx card, which comes free in the mail, and ended paying only $30. CVS is charging me $4.00/month for coverage plus $6.00 for a 3-month supply for both drugs until I meet the deductible, which I probably never will.
Find a local insurance agent who writes policies from among many insurance companies–either through AMAC or a licensed Medicare advisor. The agent I’m using doesn’t charge for administering the service.
The best insurance policy is to eat well and to take good care of ourselves. I agree with you; complicated government programs like Medicare and Obamacare contribute to higher prices across the board. Life used to be so simple before insurance became “a thing”.
Thank you for the info. I appreciate it.
Thank you for your input Kim!
You are right, this is complicated.
I agree with Kim that it makes sense to discuss your options with a local health insurance agent who specializes in Medicare plans and/or contact contact AMAC’s Medicare Advisory Service at 855-611-4856.
Regarding the medical coverage, after being in a PPO all of my working life, I decided that I didn’t want to deal with networks anymore so I said “No” to the Medicare Advantage plans and went with Original Medicare. That allows me to pick any doctor or hospital that accepts assignment from Medicare.
I also bought a Medigap (a/k/a Med Supp) plan to cover my share of Medicare Parts A & B deductibles and coinsurance. If you go this route, I would recommend selecting a Medigap plan from a well known insurance company such as Aetna, CIGNA, United Healthcare or Blue Cross Blue Shield.
Where an agent or AMAC Advisors can really help you is in selecting the prescription drug plan (Medicare Part D plan) that is best for you. The value of these plans can vary greatly depending on which prescription drugs you are currently taking. A Part D plan that is great for me because it has low monthly premium might not be a good fit for you because we are taking very different (or no) prescription drugs.
Good luck with your continuing research.
Thank you for your comments, as always, Dan! Your input certainly helps further our discussion.
We agree, understanding Medicare is the first challenge; Selecting the right plan for you is the second. It sounds like you have a pretty good grasp on how a Medicare plan may work for you, and now that you have conquered the first step allow AMAC to help you with the second.
Since we opperate as a brokerage, we can shop around for you and find you an affordable Medigap policy that will meet your needs.
Give us a call at 1-855-611-4856 to receive your complimentary quote today!
My husband and I have been on Medicare for about 10 years. The first year we had Humana which was similar to an advantage plan and it seemed like we were paying out of pocket for many extras that weren’t covered, and also for specialists. We switched to a gap insurance and we haven’t paid for anything except a few test we had o get.
On TV every other ad d for medicare advantage all day and night. The insurance companies wouldn’t be advertising-so much if they didn’t make money. It must be a good deal for them
You’re absolutely correct and explained it perfectly. We are 64 & 66 and just went through the insane process of trying to understand the plans. Take the cheap route and you will pay for it later. Enroll in a drug plan even if you aren’t on meds or you’ll pay for it later. Try boomerbenefits.com for help. They helped us and there are easy to understand videos. Highly recommend. I am not a salesman of any kind just an old lady on Medicare. Just the way they PUSH advantage plans should be warning enough to not jump on board. Take the narrow road, don’t follow the masses. You get what you pay for. Nothing is free.
So terrible what Obamacare has done to our health insurance. We are lucky to have health insurance through my husbands FEPblue and took Original Medicare and do not have to go through looking at new plans every year.
I have had a bad case of inertia on the drug plans myself. Shopping for a new drug plan can be painful.
Six years ago, I chose the CVS SilverScripts plan because it had no deductible. Then CVS bought Aetna and turned managing the CVS drug plans over to them. Aetna has slowly added a deductible to each tier of drugs so that as of January 1, 2023, all tiers will be subject to the deductible. Meanwhile, their monthly premium has been creeping up.
I finally decided to check the market and found a pharmacy plan from Wellcare at 1/3 the cost of the Aetna/CVS plan.
I am glad you found affordable prescription drug coverage Dan! WellCare is one of the many carriers we are contracted with here at AMAC, and we too have found them to be competetively priced in many areas this year.
I did the same thing for 2023. Saving $20/month just on the premium.
When part D first started, my mother and husband, who are both highly intelligent, could make neither head nor tail of the multiplicity of plans. My nursing colleagues were almost all trying to help their parents figure out the morass of plans with different “donut holes,” different meds they covered (none of them covered all mom’s meds), which pharmacies took which plans, how often you paid (monthly? Quarterly? Annually?). I finally settled on the best one after 2 solid weeks of taking every spare minute into the wee hours doing research. Next year, their premium increased to 2.5 times more than the previous year, so I had to go through it all again. Plus CVS, the pharmacy Mom insisted on using, argued about the need for every Rx every time we went for refills. We often had to ask her doctor to re-authorize all her meds. Sorry, but that takes away from doctors’ time with their patients and is a waste of time and effort, especially if a patient has been stable on the same meds for years
I am sorry to hear your experiences with Medicare have been so convoluted. Sorting through plan options and really understanding how that coverage can work for you is no easy task. At AMAC, we have a team of experienced Medicare advisors who can help you navigate the complexities of Medicare.
If you, your mom, or your husband would like a complimentary Medicare consultation, please give us a call at 1-855-611-4856.
Biggest problem with Medicare is you need a lawyer to figure it out. Spent countless hours on the phone with insurance companies trying to understand what plan is best for me. The insurance companies do this on purpose.
I hear you, Medicare is not an easy subject. We are here for you if you still need help finding a Medicare plan that is suitable for you. Please give us a call at 1-855-611-4856 and one of our experienced Medicare advisors would be happy to assist you!