New Medicare Advantage Plans in 2014

Is Obmacare killing Medicare Advantage?  Does Medicare Advantage have a future? Despite politicians’ predictions of gloom and doom for Medicare Advantage, Arizona will have several new plans in 2014.

I was going to list the new companies coming to Pima County for 2014, but then I realized I’d better not name names. One is a national company while the other is based in Phoenix.  These will be Medicare Advantage HMO plans that include drug coverage. The co-pays for these plans will be as low as, or lower than, some other plans in town, but the devil is in the details. The most important detail is the network.  Are your doctors – are all of your doctors – in the plan’s network?

Another company that is fairly new to Tucson will offer Special Needs Plans (SNP) in Pima County and Maricopa County in 2014. SNPs (pronounced “snips”) are plans for people with certain chronic illnesses such as heart disease, diabetes, and pulmonary disease.

Medicare pays SNP plans more money because people enrolled in these plans have chronic illnesses and need more medical care. Because the plan gets more money from Medicare, the co-pays for services and drugs should be lower for people enrolled in SNPs.  For example, co-pays for insulin are generally $40 – $45 on most Part D plans, but should be much lower on a Diabetes SNP plan. Same thing for inhalers on a pulmonary disease SNP.

In 2014, there will be three companies offering Chronic SNPs in Tucson and Phoenix. So people who have these chronic illnesses will have lots to compare starting on October 15th – if they are attracted by Medicare Advantage plans, or already enrolled in a Medicare Advantage plan.

But don’t forget about the network.  Are your doctors contracted with the plan?  I’ve run into a number of people who were enticed by low co-pays and forgot that they loved their Endocrinologist.  Then they were shocked several months later to realize they could no longer see their Endocrinologist because he was not contracted with the plan they joined.

Don’t like referrals?

Most HMO plans require referrals to see specialists, but two new Advantage plans will not require referrals in 2014.  There is already one plan in Pima County that is an HMO but does not require referrals.

Details not available until October 1st.

Medicare Advantage plans do not release their sales materials until October 1st because agents and brokers are not allowed to “market” plans until then.  Applications to change coverage cannot be submitted until October 15th.  New coverage begins on January 1st.

The Medicare Open Enrollment Period runs from October 15th to December 7th. This applies to Medicare Advantage and Part D. People with Medicare supplements can change their supplement company at any time during the year – if they are healthy.

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