Episode Transcript
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Speaker 1 (00:01):
Welcome to Medicare three sixty, where the world of Medicare
is simplified and you are empowered to make informed healthcare choices.
With over two decades of experience and insurance and financial
solutions with host licensed insurance agents Jennifer Lee, you are
guided through the ins and outs of medicare, whether you
(00:22):
are nearing retirement, navigating your options, or just curious about
what's available. Everything you need to know is covered. Tune
in for knowledgeable insights, tips and answers to your Medicare
questions so you can take charge of your health and
your future. And Now Medicare three sixty.
Speaker 2 (00:44):
Welcome back to another episode of Medicare three sixty Radio,
where we break down Medicare in a way that's simple, practical,
and empowering. I'm your host, Jennifer al Fons, Elite certified
Long Term Specialist, Investment Advisor, representat and proud owner of
Premiere three sixty Insurance and Financial Solutions. Today's show is
(01:05):
dedicated to something that causes more confusion than anything else
this time of year. Of course, all the phone calls,
all the letters, all the texts. I know you might
be tired of it, so annual enrollment is over right
December seventh, So what now? Every year thousands of seniors
think they miss their one and only chance to fix,
(01:28):
change or update their coverage. But the truth is you
are not stuck. You don't have options, and there are
very important steps you must take before the end of
year and even more critical planning you should do as
we head into twenty twenty six. Today's show is going
to walk you through AP recap and what changed, what
(01:52):
to do if you didn't enroll, Late plan checks, doctor
network disruptions, drug plan surprises, special enrollment periods in a
deep dive into the major Medicare changes coming in twenty
twenty six, all in a clear step by step format.
So let's speak in So what really happened during aep
(02:13):
AAP annual Roman period? This year wasn't normal. It was
one of the most intense in the last decade. I
would say. Major themes are Medicare advantage plants, tightened benefits,
more carriers pulled out of counties or merched plans. Drug
plans shrank their formularies, prior authorizations increased, doctor group's were
(02:39):
negotiated contracts. Some Medicare supplements announced twenty twenty five to
twenty twenty six increases. Carriers started preparing early for twenty
twenty six changes under the Inflation Reduction Act, and the
biggest shocker, more than forty five percent of seniors enrolled
in plans without understanding the changes of their evidence of coverage,
(03:04):
meaning many people stayed in the same plan without realizing
their plan is self changed. So by this matters, Your
coverage on January first may be completely different from you
what you had this year. So I missed the annual
romant period? Am I stuck? The short answer is known
(03:25):
the long answer. You have at least nine pathways forward,
but most seniors don't know they exist. So Option one
Medicare Advantage open enrollment period is from January first to
March thirty first, so you could switch from a Medicare
advantage to a Medicare advantage, drop a Medicare advantage, and
(03:46):
go back to original Medicare plus A Part D. You
cannot switch standalone Part D plans, so option two, if
a five star Medicare advantage plan exists in your area,
you could switch once anytime. Another Option three doctor medical
group termination special enrollment if your doctor, hospital, or medical
(04:11):
group stuff accepting your plan, you may qualify for special enrollment.
It's just really depending on the dates on that. Option
four drug coverage loss of special enrollment period, So did
you lose your employer coverage, did Cobra end? Did you
change plans? So that's the biggest thing. A lot of
my clients they're like, oh, no, December seventh is coming.
(04:35):
But if you're Part A and B is effective January first,
that is a totally different enrollment period. So you didn't
have that December seventh deadline like everyone else. Okay, what
else extra help? So Medicaid special enrollment, so you can't
(04:56):
qualify if you switch your plans quarterly for that. If
you have like a change on your Medicaid or medical
in California, that is also a change. Option six FEMA
Disaster special enrollment. If there was a declared disaster in
your county during AP you may still be allowed to
enroll now. Option seven chronic condition, So these are the
(05:22):
special needs plans like conditions like diabetes, COPD, congestive heartfielder
may qualify for year round plan changes only once a
year though. Option eight moving to a new service area,
so any address changes triggers in special enrollment period from
county to county, because typically from county to county plants
(05:45):
may change. There are some combinations sometimes that there's different
combos with counties too, so option nine plan termination or
reduction in your service area. If your plan exits, you
get a free switch, which so end of year Medicare checklists,
verify your doctors and medical groups. So this is one
(06:08):
of the most important parts of the show. Contract changes
are more common than ever. Don't assume you're still accepted
just because they were in network before. Colin ass while
you still be accepting my Medicare advantage PLAT for twenty
twenty five. So this is a big thing. It's causing
a lot of confusion because depending on the insurance company
(06:31):
you're with, either that person has no clue, has not
read the memos or bulletins of the changes in your area,
or honestly they could. They could be lying to you
or misinforming you or misrepresenting you. I've seen it time
and time and again. So please call your doctor's office,
(06:56):
your provider, your medical group. Sometimes even that they could
refer you to an agent. Just make sure because with
that sometimes they don't know all the plans. Ins and
outs either, but they should have a better indication. Then
let's just say the insurance company that may not even
be taking your doctors and specialists. Okay, so double check
(07:23):
your prescription drug costs. Even if the plan name stays
the same, tiers could change. Right. The tiers are one
generic and prefer generic to generic, three brand name for
specialty and so forth. Right, so codepase could have increased,
deductibles could have increased prior authorizations are added. Right, doesn't
(07:46):
mean that it was denied. There's just authorizations that your
doctor needs to send, you needs to send the insurance
company and step up therapy. Added confirmation of hospitals and
urgent cares. Medicare Adventure plans are prioritizing value based groups
and reducing access to some hospitals, so that is important.
(08:07):
Check your over the counter benefits. Most do expire at
the year and use it or lose it. Check your
dental allowances. Major services often have annual maximums, so let
me rewind to OTC over the counter so sometimes they
(08:28):
they're renewed from quarter to quarter, a month to month,
but they do expire at the end of the year.
So if you are going to like your local pharmacy
or doing mail order, call order online. Do it at
the end of By the end of the year, sometimes
there's a lot of items that are sold out. That's
(08:48):
why I do it as soon as you can. Check
your dental allowances. The biggest thing on this is major
services often have annual maximumsug Your dental plan may have
chain it could have been increased, could have been decreased,
So look at that review Medicare supplemental rates, so if
your Medigap premium is rising ten to twenty percent, you
(09:10):
may say by switching. So underwriting varies by state. Keep
in mind Medicare supplement doesn't have the annual moment of
December seventh, right. If you're on a birthday rule state
like California, you're able to switch on your birthday without
any underwriting, So that doesn't really apply. It's just your
prescription drug plan. That's what you have to look at
(09:33):
your tiers, your formulas to make sure your drugs are
still covered at a reasonable premium and price copay. So
check for unused benefits, I mean transportation. You can't really
use analysts. You go to the doctor's healthy food cards.
Did you use it all? Gym vision hearing allowances. They
(09:53):
do expire twelve thirty one, so keep that in mind. Okay,
so let's talk about people who have missed ap The
biggest one this year is my doctor left the plan
and I didn't know. So mister Robert was shocked to
(10:17):
learn his primary doctor group dropped his Medicare advantage effective January. First,
he qualified for a special enrollment he didn't know existed. Right,
So I've had it where clients are out of town
for the whole month and they just got in and
not knowing all these changes, because these changes could have
been in a rush. So with this, definitely call us
(10:41):
or your license licensed independent agent to help you with this.
That's a big thing. Okay, my drug went from five
fifty dollars to three hundred dollars overnight, So yes, this
could change, right, Formularities could change the tier changes prior
(11:02):
authorizations needed, no notification sent. Happens every year. So like,
the biggest thing I see is like I sometimes review
clients drugs right and generic and prefer generic. Those are
typically the same. But if it's like sometimes like a
drug is just not covered anymore, and the biggest thing
you have to do there is get a formulary exception
(11:25):
or a tear exception with insurance company and hopefully they
approve it. So that's something big. Okay. So my supplement
premium gen forty two dollars per month. So many seniors
think metagap premiums are fixed. They're not, so we could
definitely help and we save clients six hundred to two
thousand a couple four thousand a year on that. Okay,
(11:50):
So massive shifts are coming in twenty twenty six. So
one drug price Negotiation Phase two there are more negotiated drugs,
lower prices, but with that comes formularies will shrink as
a plan cut costs, right, so meaning your drugs may
not be covered. So check that part D redesign no
(12:13):
more five percent catastrophic coinsurance. I mean that went away
this year with a donut hole. Annual cap is twenty
one hundred and twenty twenty six. Manufacturers are taking on
more responsibility. And you know, if you are on a
really expensive drug, there are like foundations or manufactured discounts
or savings programs that could help you with that. And
(12:35):
then plans tiding formularies to compensate. Just the part do
you redesign, so prior authorizations explosion. Expect twenty to thirty
percent more prior authorizations as plans control costs. Right, that's
why it's better to be informed and know what's going
(12:57):
on with your plan, so provide network disruptions. Doctor groups
are been renegotiating Medicare advantaged contracts, more will drop low
and reimbursement plans. Hospitals are pulling out, and i pas
are consolidating. Okay, so that is the number one biggest
(13:18):
disruptor that has happened this year. I've experienced it. I've
helped so many clients this year with that because of that. Okay,
so risk rise of risk based care. Medical groups owned
by private equity or hospitals will decide who gets referrals,
(13:40):
which specialists you could see how quickly care is delivered.
And then changes in marketing rules, agents space, stricter compliance,
I viewer marketing events, more recorded calls, and just flexibility
so consumers may get less personal help. But not to worry.
(14:01):
We hear at Premier thirty sixty could help you with that.
Supplement Premium increases expect seven to eighteen percent hikes across
many states due to rising claims. So that's the Medicare
supplement plans. If you have that, So what do you
do right now? Okay, review your plan. So if you
(14:25):
have not reviewed it, go review your plan. You do
still have some time. Even if think you're fine, even
things something is different, review it, right. I know many
may go on Medicare dot gov and the biggest differentiator
when someone does go to Medicare dot gov and looks
(14:46):
at their plan, You're just seeing numbers, right, You're not
seeing the full picture of an independent agent that could
make sure that you're all your doctors aligned in a
medical group that doesn't show it. There the just landscape
of insurance companies, the stability, the instability of different ones,
(15:09):
and just what's going on. Right. I have clients that say, Jennifer,
this is the one, and I walk it through and
it might not be the one, just because of my
in depth knowledge of being in the industry, knowing what's
going on with the industry. So that's the biggest thing. Right.
You can definitely go and do everything yourself, but a second,
(15:33):
I second confirmation of your choices will definitely help and escalation, right,
because sometimes you're just a name and a number when
you call the insurance company, they don't know you. How
much do they care if you're never going to talk
to them again? Right, With an independent agent, you're building
(15:57):
that relationship if you need something escalating, that's what we're
here for. So remember evaluate your medications. Prioritize expensive or
brand name meds. That's the thing, right, You just really
want to make sure what's the cost so there's no surprises.
Step three, check your doctor status, plan and groups really
notify patients properly. Sometimes I have it, Jennifer. Why did
(16:21):
my wife get the letter? But I didn't, right, So
just you know, sometimes it does fall through the cracks
like that, or even just maybe not the specific medical group.
Maybe your doctor just left the medical group retired. What
be it? You just need to make sure get a
risk review, especially if you rely on heavily on specialists.
(16:44):
I would do that. Understand your twenty twenty six exposure.
So if you do have like diabetes, cancer, heart disease,
autoimmune conditions, your twenty twenty six coverage well will change
the most, but I mean hopefully it's something for the better.
(17:04):
When you do have a chronic condition, there are still
plans that are going on strong right, So just keep
that in mind that your plan maybe just down the drain,
meaning they just took so many benefits off. Two they're
(17:25):
just okay stable. Or three your plan could have increased
benefits and you definitely want to know that two as well. Okay,
So just my personal thoughts on annual enrollment. I almost
(17:45):
help maybe four hundred clients and in about two to
three weeks, right, So I am definitely tired, but I
am rewarded, and I feel rewarded for helping because this
is not your job, this is not your career and
your livelihood. I mean, it's something that you need, but
(18:07):
you know you were certified our license for this. So
in a landscape to things, Number One, seniors do want stability.
Seniors want to make sure that they have their doctors
and their network covered. That's like the biggest thing, right,
(18:27):
And they are willing to change their plan even if
they have been in that insurance company maybe for twenty
thirty years, because that's what I've encountered. My older senior
clients tend not to care about benefits that much. They
tend to care that their doctors are just in the
(18:47):
network that they could still keep their doctors that they're
not paying any exorbitant fees, right, And sometimes with that,
having insurance plan for twenty to thirty years, you don't
even know if it's good if you didn't review it, right,
But I get it. People like comfort. People want to
(19:10):
just know what they have is good. Right. So with
the changes in the marketplace, many seniors in their eighties, nineties,
and I even had some hundred year olds had to
were forced to a new plan that actually might have
given better benefits and lower costs. So that's good my
(19:35):
turning sixty five seniors, they're more value conscious. They want
obviously still lowest maximum out of cost and benefits, but
really because they are they know they could change their
plan yearly, and they're not afraid of that change. They
(19:56):
want benefits. So what benefits Because you are paying through
insurance company, right, so they are paying We're not paying
insurance company. You paid Medicare throughout all your years. You
want to make sure that you're getting the most bang
for your buck. So I do see that, Well, that's
(20:19):
great in just giving the best benefits for that year,
it just comes to like changing the plan the following year,
right when there's no instability, so keeping that in mind
as well, and then you know, you have your middle grounds,
and then you have those special cases where you're seeing
(20:41):
doctors and specialists that might just not be in the network,
which is very unfortunate as well. But it has been
I would say, a really disruptive year for all of
US US agents, and we do ask for members grace
(21:08):
and patience to allow us some grace because we are
just trying to help as many seniors are as possible, right,
especially the ones that are getting false information. I even
had one senior that called me back and said, Jennifer,
the plan you gave me is fake. It doesn't exist.
(21:29):
So come to find out, another agent called her was
trying to have her switch. And so seniors do want confidence,
and I did stand my ground. I did tell her
I was local and I would not jeopardize my career,
my licenses, my certificates to put her in a plan
(21:53):
that was not that was fake, right, So I reassured
her with her benefits, and she said, you know what,
I'm going to do more research. And actually she's like,
before I talk to that person, And she did actually
(22:14):
call my office back and said, you know what, I
am sticking with a plan I did my research and
due diligence, So I just hate the tactics of these
unethical agents trying to scare you or your loved ones.
So I do detest that. But if that has happened
(22:37):
to your loved ones, you could definitely still make changes
from January to March. So if you are listening right
now and you're unsure whether your plan is still the
best fit, or if you missed AP and you think
you're stuck, you are not alone. This year, more seniors
than ever are confused, and the twenty twenty six changes
(22:59):
will make things even more complicated. So here's my offer.
A complimentary Medicare year end and twenty twenty six readiness
review will help you understand your plan, evaluate your drugs,
confirm your doctors, identify any risks, prepare for twenty twenty
six changes, and uncover possible savings or better options. So
(23:26):
what we want to do is we just want to
make sure you're protected, confident, and fully prepared for the
biggest Medicare changes in the decade. So I'm your host,
Jennifer Alfonso Lee with Premiere three sixty. I look forward
(23:47):
to our next conversation. Okay, talk to you guys soon.
Thank you byebye.
Speaker 1 (23:55):
Thank you for joining the program Medicare three sixty. Hope
you found today episode insightful and empowering. Remember, understanding your
Medicare options is key to making the right choices for
your health and financial well being. If you have questions
or topics you would like covered in future episodes of
Medicare three sixty, don't hesitate to reach out and speak
(24:18):
with our licensed insurance agent Until next time, Stay informed
and take charge of your healthcare journey. This has been
Medicare three sixty, your trusted source for all things Medicare.
Take care
Welcome to Medicare three sixty, where the world of Medicare
is simplified and you are empowered to make informed healthcare choices.
With over two decades of experience and insurance and financial
solutions with host licensed insurance agents Jennifer Lee, you are
guided through the ins and outs of medicare, whether you
(00:22):
are nearing retirement, navigating your options, or just curious about
what's available. Everything you need to know is covered. Tune
in for knowledgeable insights, tips and answers to your Medicare
questions so you can take charge of your health and
your future. And Now Medicare three sixty.
Speaker 2 (00:44):
Welcome back to another episode of Medicare three sixty Radio,
where we break down Medicare in a way that's simple, practical,
and empowering. I'm your host, Jennifer al Fons, Elite certified
Long Term Specialist, Investment Advisor, representat and proud owner of
Premiere three sixty Insurance and Financial Solutions. Today's show is
(01:05):
dedicated to something that causes more confusion than anything else
this time of year. Of course, all the phone calls,
all the letters, all the texts. I know you might
be tired of it, so annual enrollment is over right
December seventh, So what now? Every year thousands of seniors
think they miss their one and only chance to fix,
(01:28):
change or update their coverage. But the truth is you
are not stuck. You don't have options, and there are
very important steps you must take before the end of
year and even more critical planning you should do as
we head into twenty twenty six. Today's show is going
to walk you through AP recap and what changed, what
(01:52):
to do if you didn't enroll, Late plan checks, doctor
network disruptions, drug plan surprises, special enrollment periods in a
deep dive into the major Medicare changes coming in twenty
twenty six, all in a clear step by step format.
So let's speak in So what really happened during aep
(02:13):
AAP annual Roman period? This year wasn't normal. It was
one of the most intense in the last decade. I
would say. Major themes are Medicare advantage plants, tightened benefits,
more carriers pulled out of counties or merched plans. Drug
plans shrank their formularies, prior authorizations increased, doctor group's were
(02:39):
negotiated contracts. Some Medicare supplements announced twenty twenty five to
twenty twenty six increases. Carriers started preparing early for twenty
twenty six changes under the Inflation Reduction Act, and the
biggest shocker, more than forty five percent of seniors enrolled
in plans without understanding the changes of their evidence of coverage,
(03:04):
meaning many people stayed in the same plan without realizing
their plan is self changed. So by this matters, Your
coverage on January first may be completely different from you
what you had this year. So I missed the annual
romant period? Am I stuck? The short answer is known
(03:25):
the long answer. You have at least nine pathways forward,
but most seniors don't know they exist. So Option one
Medicare Advantage open enrollment period is from January first to
March thirty first, so you could switch from a Medicare
advantage to a Medicare advantage, drop a Medicare advantage, and
(03:46):
go back to original Medicare plus A Part D. You
cannot switch standalone Part D plans, so option two, if
a five star Medicare advantage plan exists in your area,
you could switch once anytime. Another Option three doctor medical
group termination special enrollment if your doctor, hospital, or medical
(04:11):
group stuff accepting your plan, you may qualify for special enrollment.
It's just really depending on the dates on that. Option
four drug coverage loss of special enrollment period, So did
you lose your employer coverage, did Cobra end? Did you
change plans? So that's the biggest thing. A lot of
my clients they're like, oh, no, December seventh is coming.
(04:35):
But if you're Part A and B is effective January first,
that is a totally different enrollment period. So you didn't
have that December seventh deadline like everyone else. Okay, what
else extra help? So Medicaid special enrollment, so you can't
(04:56):
qualify if you switch your plans quarterly for that. If
you have like a change on your Medicaid or medical
in California, that is also a change. Option six FEMA
Disaster special enrollment. If there was a declared disaster in
your county during AP you may still be allowed to
enroll now. Option seven chronic condition, So these are the
(05:22):
special needs plans like conditions like diabetes, COPD, congestive heartfielder
may qualify for year round plan changes only once a
year though. Option eight moving to a new service area,
so any address changes triggers in special enrollment period from
county to county, because typically from county to county plants
(05:45):
may change. There are some combinations sometimes that there's different
combos with counties too, so option nine plan termination or
reduction in your service area. If your plan exits, you
get a free switch, which so end of year Medicare checklists,
verify your doctors and medical groups. So this is one
(06:08):
of the most important parts of the show. Contract changes
are more common than ever. Don't assume you're still accepted
just because they were in network before. Colin ass while
you still be accepting my Medicare advantage PLAT for twenty
twenty five. So this is a big thing. It's causing
a lot of confusion because depending on the insurance company
(06:31):
you're with, either that person has no clue, has not
read the memos or bulletins of the changes in your area,
or honestly they could. They could be lying to you
or misinforming you or misrepresenting you. I've seen it time
and time and again. So please call your doctor's office,
(06:56):
your provider, your medical group. Sometimes even that they could
refer you to an agent. Just make sure because with
that sometimes they don't know all the plans. Ins and
outs either, but they should have a better indication. Then
let's just say the insurance company that may not even
be taking your doctors and specialists. Okay, so double check
(07:23):
your prescription drug costs. Even if the plan name stays
the same, tiers could change. Right. The tiers are one
generic and prefer generic to generic, three brand name for
specialty and so forth. Right, so codepase could have increased,
deductibles could have increased prior authorizations are added. Right, doesn't
(07:46):
mean that it was denied. There's just authorizations that your
doctor needs to send, you needs to send the insurance
company and step up therapy. Added confirmation of hospitals and
urgent cares. Medicare Adventure plans are prioritizing value based groups
and reducing access to some hospitals, so that is important.
(08:07):
Check your over the counter benefits. Most do expire at
the year and use it or lose it. Check your
dental allowances. Major services often have annual maximums, so let
me rewind to OTC over the counter so sometimes they
(08:28):
they're renewed from quarter to quarter, a month to month,
but they do expire at the end of the year.
So if you are going to like your local pharmacy
or doing mail order, call order online. Do it at
the end of By the end of the year, sometimes
there's a lot of items that are sold out. That's
(08:48):
why I do it as soon as you can. Check
your dental allowances. The biggest thing on this is major
services often have annual maximumsug Your dental plan may have
chain it could have been increased, could have been decreased,
So look at that review Medicare supplemental rates, so if
your Medigap premium is rising ten to twenty percent, you
(09:10):
may say by switching. So underwriting varies by state. Keep
in mind Medicare supplement doesn't have the annual moment of
December seventh, right. If you're on a birthday rule state
like California, you're able to switch on your birthday without
any underwriting, So that doesn't really apply. It's just your
prescription drug plan. That's what you have to look at
(09:33):
your tiers, your formulas to make sure your drugs are
still covered at a reasonable premium and price copay. So
check for unused benefits, I mean transportation. You can't really
use analysts. You go to the doctor's healthy food cards.
Did you use it all? Gym vision hearing allowances. They
(09:53):
do expire twelve thirty one, so keep that in mind. Okay,
so let's talk about people who have missed ap The
biggest one this year is my doctor left the plan
and I didn't know. So mister Robert was shocked to
(10:17):
learn his primary doctor group dropped his Medicare advantage effective January. First,
he qualified for a special enrollment he didn't know existed. Right,
So I've had it where clients are out of town
for the whole month and they just got in and
not knowing all these changes, because these changes could have
been in a rush. So with this, definitely call us
(10:41):
or your license licensed independent agent to help you with this.
That's a big thing. Okay, my drug went from five
fifty dollars to three hundred dollars overnight, So yes, this
could change, right, Formularities could change the tier changes prior
(11:02):
authorizations needed, no notification sent. Happens every year. So like,
the biggest thing I see is like I sometimes review
clients drugs right and generic and prefer generic. Those are
typically the same. But if it's like sometimes like a
drug is just not covered anymore, and the biggest thing
you have to do there is get a formulary exception
(11:25):
or a tear exception with insurance company and hopefully they
approve it. So that's something big. Okay. So my supplement
premium gen forty two dollars per month. So many seniors
think metagap premiums are fixed. They're not, so we could
definitely help and we save clients six hundred to two
thousand a couple four thousand a year on that. Okay,
(11:50):
So massive shifts are coming in twenty twenty six. So
one drug price Negotiation Phase two there are more negotiated drugs,
lower prices, but with that comes formularies will shrink as
a plan cut costs, right, so meaning your drugs may
not be covered. So check that part D redesign no
(12:13):
more five percent catastrophic coinsurance. I mean that went away
this year with a donut hole. Annual cap is twenty
one hundred and twenty twenty six. Manufacturers are taking on
more responsibility. And you know, if you are on a
really expensive drug, there are like foundations or manufactured discounts
or savings programs that could help you with that. And
(12:35):
then plans tiding formularies to compensate. Just the part do
you redesign, so prior authorizations explosion. Expect twenty to thirty
percent more prior authorizations as plans control costs. Right, that's
why it's better to be informed and know what's going
(12:57):
on with your plan, so provide network disruptions. Doctor groups
are been renegotiating Medicare advantaged contracts, more will drop low
and reimbursement plans. Hospitals are pulling out, and i pas
are consolidating. Okay, so that is the number one biggest
(13:18):
disruptor that has happened this year. I've experienced it. I've
helped so many clients this year with that because of that. Okay,
so risk rise of risk based care. Medical groups owned
by private equity or hospitals will decide who gets referrals,
(13:40):
which specialists you could see how quickly care is delivered.
And then changes in marketing rules, agents space, stricter compliance,
I viewer marketing events, more recorded calls, and just flexibility
so consumers may get less personal help. But not to worry.
(14:01):
We hear at Premier thirty sixty could help you with that.
Supplement Premium increases expect seven to eighteen percent hikes across
many states due to rising claims. So that's the Medicare
supplement plans. If you have that, So what do you
do right now? Okay, review your plan. So if you
(14:25):
have not reviewed it, go review your plan. You do
still have some time. Even if think you're fine, even
things something is different, review it, right. I know many
may go on Medicare dot gov and the biggest differentiator
when someone does go to Medicare dot gov and looks
(14:46):
at their plan, You're just seeing numbers, right, You're not
seeing the full picture of an independent agent that could
make sure that you're all your doctors aligned in a
medical group that doesn't show it. There the just landscape
of insurance companies, the stability, the instability of different ones,
(15:09):
and just what's going on. Right. I have clients that say, Jennifer,
this is the one, and I walk it through and
it might not be the one, just because of my
in depth knowledge of being in the industry, knowing what's
going on with the industry. So that's the biggest thing. Right.
You can definitely go and do everything yourself, but a second,
(15:33):
I second confirmation of your choices will definitely help and escalation, right,
because sometimes you're just a name and a number when
you call the insurance company, they don't know you. How
much do they care if you're never going to talk
to them again? Right, With an independent agent, you're building
(15:57):
that relationship if you need something escalating, that's what we're
here for. So remember evaluate your medications. Prioritize expensive or
brand name meds. That's the thing, right, You just really
want to make sure what's the cost so there's no surprises.
Step three, check your doctor status, plan and groups really
notify patients properly. Sometimes I have it, Jennifer. Why did
(16:21):
my wife get the letter? But I didn't, right, So
just you know, sometimes it does fall through the cracks
like that, or even just maybe not the specific medical group.
Maybe your doctor just left the medical group retired. What
be it? You just need to make sure get a
risk review, especially if you rely on heavily on specialists.
(16:44):
I would do that. Understand your twenty twenty six exposure.
So if you do have like diabetes, cancer, heart disease,
autoimmune conditions, your twenty twenty six coverage well will change
the most, but I mean hopefully it's something for the better.
(17:04):
When you do have a chronic condition, there are still
plans that are going on strong right, So just keep
that in mind that your plan maybe just down the drain,
meaning they just took so many benefits off. Two they're
(17:25):
just okay stable. Or three your plan could have increased
benefits and you definitely want to know that two as well. Okay,
So just my personal thoughts on annual enrollment. I almost
(17:45):
help maybe four hundred clients and in about two to
three weeks, right, So I am definitely tired, but I
am rewarded, and I feel rewarded for helping because this
is not your job, this is not your career and
your livelihood. I mean, it's something that you need, but
(18:07):
you know you were certified our license for this. So
in a landscape to things, Number One, seniors do want stability.
Seniors want to make sure that they have their doctors
and their network covered. That's like the biggest thing, right,
(18:27):
And they are willing to change their plan even if
they have been in that insurance company maybe for twenty
thirty years, because that's what I've encountered. My older senior
clients tend not to care about benefits that much. They
tend to care that their doctors are just in the
(18:47):
network that they could still keep their doctors that they're
not paying any exorbitant fees, right, And sometimes with that,
having insurance plan for twenty to thirty years, you don't
even know if it's good if you didn't review it, right,
But I get it. People like comfort. People want to
(19:10):
just know what they have is good. Right. So with
the changes in the marketplace, many seniors in their eighties, nineties,
and I even had some hundred year olds had to
were forced to a new plan that actually might have
given better benefits and lower costs. So that's good my
(19:35):
turning sixty five seniors, they're more value conscious. They want
obviously still lowest maximum out of cost and benefits, but
really because they are they know they could change their
plan yearly, and they're not afraid of that change. They
(19:56):
want benefits. So what benefits Because you are paying through
insurance company, right, so they are paying We're not paying
insurance company. You paid Medicare throughout all your years. You
want to make sure that you're getting the most bang
for your buck. So I do see that, Well, that's
(20:19):
great in just giving the best benefits for that year,
it just comes to like changing the plan the following year,
right when there's no instability, so keeping that in mind
as well, and then you know, you have your middle grounds,
and then you have those special cases where you're seeing
(20:41):
doctors and specialists that might just not be in the network,
which is very unfortunate as well. But it has been
I would say, a really disruptive year for all of
US US agents, and we do ask for members grace
(21:08):
and patience to allow us some grace because we are
just trying to help as many seniors are as possible, right,
especially the ones that are getting false information. I even
had one senior that called me back and said, Jennifer,
the plan you gave me is fake. It doesn't exist.
(21:29):
So come to find out, another agent called her was
trying to have her switch. And so seniors do want confidence,
and I did stand my ground. I did tell her
I was local and I would not jeopardize my career,
my licenses, my certificates to put her in a plan
(21:53):
that was not that was fake, right, So I reassured
her with her benefits, and she said, you know what,
I'm going to do more research. And actually she's like,
before I talk to that person, And she did actually
(22:14):
call my office back and said, you know what, I
am sticking with a plan I did my research and
due diligence, So I just hate the tactics of these
unethical agents trying to scare you or your loved ones.
So I do detest that. But if that has happened
(22:37):
to your loved ones, you could definitely still make changes
from January to March. So if you are listening right
now and you're unsure whether your plan is still the
best fit, or if you missed AP and you think
you're stuck, you are not alone. This year, more seniors
than ever are confused, and the twenty twenty six changes
(22:59):
will make things even more complicated. So here's my offer.
A complimentary Medicare year end and twenty twenty six readiness
review will help you understand your plan, evaluate your drugs,
confirm your doctors, identify any risks, prepare for twenty twenty
six changes, and uncover possible savings or better options. So
(23:26):
what we want to do is we just want to
make sure you're protected, confident, and fully prepared for the
biggest Medicare changes in the decade. So I'm your host,
Jennifer Alfonso Lee with Premiere three sixty. I look forward
(23:47):
to our next conversation. Okay, talk to you guys soon.
Thank you byebye.
Speaker 1 (23:55):
Thank you for joining the program Medicare three sixty. Hope
you found today episode insightful and empowering. Remember, understanding your
Medicare options is key to making the right choices for
your health and financial well being. If you have questions
or topics you would like covered in future episodes of
Medicare three sixty, don't hesitate to reach out and speak
(24:18):
with our licensed insurance agent Until next time, Stay informed
and take charge of your healthcare journey. This has been
Medicare three sixty, your trusted source for all things Medicare.
Take care
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