Was your open enrollment review good, bad or ugly?

HappyHolidays! I hope everyone’s preparations for family and friends this holidayseason is going well. There’s a lot of things going on this time of year tokeep us all busy.  As I mentioned in my last blog, one of the mostimportant year end tasks is reviewing your Medicare insurance coverage,including your Part D prescription drug plan.  Because I moved to adifferent state it was especially important that I reviewed my coverage and indoing so I had some interesting experiences and some money savingdiscoveries.  I think by going through some of the decisions and tradeoffsI had to make, they might help us all better understand the policies andregulations that are in place now or how the changes that are being consideredby our leaders in Washington might affect each one of us.

As Imentioned I moved to a different state and that move gave me some broaderchoices.  Previously, I had a supplemental insurance plan and astand-alone Part D plan.  The availability of Medicare Advantage plans inmy old state were limited so a supplemental plan was the best choice for mywife and myself.  In my new state I had the choice of various Medicaresupplemental plans, but I also had the choice of five different MedicareAdvantage plans.  Since the premiums are often less or zero with MedicareAdvantage, I was very interested in what these five plans had to offer. Here are just a few things that I had to consider when looking at the MedicareAdvantage plans offered in my state:

• Were my new doctors in the PPOs?
• What doctors were part of the HMOs?
• What would my new premiums be?
• What were the copays for an office visit to my primary care doctor?
• What were the copays for an office visit to specialists?
• What was the copay for a visit to the emergency room?
• Did the plan include Part D, if so, did it cover the prescription drugs that we currently use?
• What were the copays on the medication?
• Was any medication on specialty tiers?
• Was coinsurance part of the plan, if so, what was the percentage? 
• What was the yearly out-of-pocket maximum for health services?
• Did the plan include dental, hearing, eyesight or other benefits (like silver sneakers)?

There was alot to consider and a lot of acronyms and terms that I had to understand. It was no small task and took considerable time.  It was a little easiergiven I’ve been involved in health care policy for over 20 years, but it wasstill time consuming and arduous at times.  After I had made mypreliminary decision, I used another resource that was available to me as amilitary veteran.  When I first joined the Air Force, I had theopportunity to use USAA for my car insurance.  I’ve gone on to use themfor other insurance and financial needs and they offer a phone number andassistance for choosing insurance plans.  I’m not selling USAA products, Idon’t sell anything on this blog, but I want to remind you that you shouldresearch all the resources available to you and take advantage of any helpavailable.  I did and was very pleased with the help and advice I got fromthe USAA person.

In the end Ichose a Medicare Advantage PPO plan and found that I saved a large amount ofmoney on premiums.  I had to balance that with an increase in my yearlyout-of-pocket maximum and some higher copays.  I’ll have to see what kindof care I receive, but on balance I think I will be better off.

I hope youare satisfied with your insurance or made a change during this open enrollmentperiod that will give you better benefits or cost less.  As I’ve saidbefore this blog will focus on you, the consumer and the impact thatregulations and legislation will have on your access and cost.  Healthcare is complicated, you probably had that driven home as you reviewed yourcoverage.  I will work to try to simplify the Washington rhetoric and boilthings down to show how their proposals and solutions will affect you.As part of thisendeavor my next blog will define some of the terms that are used in healthcare insurance, regulations and legislation.  My definitions will focus onhow these different items affect you and your level of care orpocketbook.  Ever wonder what the difference is between copay andcoinsurance?  Watch for my next blog, that will strive to demystify thiscomplicated thing we call health care.