Changes are coming to Medicare Advantage plans. I’ve been attending meetings for independent brokers who represent Medicare Advantage plans in Southern Arizona and my head is spinning with news of changes big and small.
I need to contact my clients who are enrolled in plans that will have fairly substantial changes (like entire plan cancellations) as well as potential changes to their drug formulary. They might or might not be affected by changes to a drug formulary, and they might not care if Silver Sneakers is no longer an additional benefit offered through their Medicare Advantage plan. But then again, these changes might be very important to them.
SILVER SNEAKERS DROPPED
One Medicare Advantage plan will be dropping the Silver Sneakers benefit as of January 2014. Sorry I can’t name names, but you can email me if you want to know which one.
DRUG COVERAGE CHANGE
One Medicare Advantage company is changing its Part D coverage to include a $310 deductible. UPDATE 9/21: The company has informed brokers that their MA plan will not have a deductible in its drug coverage. I was about to call one of my clients to ask if I could see the Annual Notice of Change (if she has received it). Sometimes procrastination is a good thing. She lives near me, so I’ll ask to see the ANOC just so I know what it looks like..
They say it’s not a big deal because so many people use only generics which they can get for $4 at Walmart. It may not be a big deal price-wise, but it will create plenty of confusion for people who can’t comprehend how a deductible works. It will probably also cause many people to change their Medicare Advantage plan to one that has no Part D deductible.
Another company is changing its Part D formulary for one of its Medicare Advantage plans – but not all of its plans. It’s most popular plan will have a different drug formulary, but they could not tell us exactly what this means. Usually it means a more limited list of drugs that will be covered.
READ THE ANOC!!
An Annual Notice of Change (ANOC) is sent to everyone enrolled in a Medicare Advantage plan or Part D plan. This material arrives near the end of September and has 30 or more pages. I think it arrives with other plan information for 2014, so it can get lost in the shuffle of what most people consider junk mail from their Medicare Advantage plan.
I recall reading through an ANOC with one of my clients last year and being confused. I didn’t think it was very well organized in terms of benefits that were changing. We had to read through the ANOC several times to be sure we understood everything that was changing.
DRUG COVERGE CHANGES?
I don’t recall exactly how the ANOC handles changes to their drug coverage, but I think they list drugs that will change from one tier to another (thus changing the co-pay for the consumer). It should also list drugs that are no longer being covered.
This was a big deal last year for people who took Lipitor because it went generic. Some Medicare Advantage companies changed the Lipitor co-pay from $45 to $90 while other companies decided not to cover the brand version for 2013. How many people saw this in their ANOC? I know a few who were shocked when they went to pick up their Lipitor in February or March of this year and had no idea they should be taking Atorvastatin instead of Lipitor.
MORE CHANGE INFORMATION TO COME:
NEW PLANS IN PIMA COUNTY.