Annual Enrollment is Over. Now What?
I’m exhausted after having helped 148 people write their medical plans for 2026 - but that is 148 people who won’t be suffering with copays they can’t afford, medicines they can’t afford, or benefits that don’t perform the way they expected.
So, I want to thank you for your trust and the opportunity to make a difference in your lives for the better. A number of people moved from financially crushing Medicare Supplements to Medicare Advantage paired with hospital indemnity plans that saved them as much as $1100 a month.
Going from an annual premium cost of over $13,000 to a max out of pocket around $4,200 that may or may not ever happen. If you’re using local doctors and hospitals or your specialists are in major Texas cities (even Tyler or Longview) or Shreveport/Bossier, a move like this can be a game-changer in terms of medical risk management and financial protection.
What if you didn’t get a plan? There are several situations where you still can.
** If you have a Medicare advantage plan now and still need to make a change, you can do that in January - for a February 1 start date.
** If you have lost your Medicare advantage plan because the company dropped it and you are panicking now, there is a special enrollment code that will allow me to help you immediately for a January 1 start date. But it is for that reason only.
Annual Enrollment in the fall, and Open Enrollment in the first quarter (January - March), Special Election Periods (SEP’s), and Dual Eligibility are all part-and-parcel of Medicare Advantage and Prescription Drug Plans (PDPs) only. If you are on a Medicare Supplement and need help you can still, make some changes - as long as you are not attempting to switch to Medicare Advantage.
Open Enrollment is coming in January for Medicare Advantage members who want to make a change - but you only get one. Unlike Annual Enrollment in the fall when you can enroll in as many as you want and have the last enrollment be the one that sticks. I was enrolling people until 11 p.m. last night.
If you didn’t make a change during AEP and you get blindsided with prescription copays or something you didn’t expect, call me. I can help you find a plan that works better for you. Or, if you want to talk about protecting yourself from some of the larger co-pays associated with Medicare Advantage, it’s time to have a conversation about hospital indemnity coverage that is very inexpensive and pays you directly.
Now is the perfect time to apply for the Part D Extra Help program with Social Security - just go to www.ssa. gov/medicare/part-d-extra-help or call the SSA at 800772-1213. If you qualify, deductibles are waived, plan premiums (usually up to $50/month) are paid for you, prescription costs are lowered significantly and more. It doesn’t matter if you are on a PDP or MAPD plan it still pays.
If your income is below $2000, I recommend applying for Medicaid and the Medicare Savings Program. You may not get Medicaid, but the MSP could pay your Part B Premium every month - that’s $202.90 back in your Social Security check every month. I’m not sure what the income limits are for the program and everyone’s situation is different so just apply.
If you’re struggling with dental woes, I have a great plan that pays 100% of preventative immediate, 70% of basic services including extractions and fillings also immediately, and 70% of major services after 1 year. The 12-month wait is standard in the US. Everyone requires it for full benefits. This plan will also cover implants at the major level. Costs run around $50 per person. Anyone can get this plan - you don’t have to be on Medicare. They also have a vision/hearing rider with VSP that pays well for glasses and hearing tests with a discount on hearing aids.
Next week I’ll be laying out the Medicare/Medicaid relationship and discussing dual eligibility.
Don’t forget the local food drives, I know the Lion’s Club has a big one coming up from 10 a.m. to 2 p.m. on Saturday, Dec. 13 at Brookshires to build holiday food boxes.
Wishing all of you a blessed and safe week. Remember that I am here for you.
~ Amy
Amelia (Amy) Gunstanson is a Navy Veteran with 30 years’ experience in life and health insurance, the last six years in Medicare specifically. She is the Principal Agent/ owner of Medicare Thrive in Atlanta, TX, serving Cass and surrounding areas. She is federally certified, licensed in 20 states and appointed/certified with many major carriers including Kemper Life, Humana, United Healthcare, Physicians Mutual, Christus, Aetna, Cigna Blue Cross and more. You can call or text questions or requests for appointments to 430-999-2271 or on the web at www.medicarethrive. com.