By ROB JONAS
This is the critical part of the year for Medicare enrollees. Open enrollment begins Thursday, Oct. 15. Through December 7, enrollees have the ability to renew or change their Medicare Advantage and prescription plans for 2021.
At DGAlcorn & Associates in Niskayuna, the goal is to help Medicare enrollees select the plan that best suits their needs.
“This period allows them to select the plan best matched to their doctors, prescription medications, their travel plans and, of course, budget,” said DGAlcorn & Associates General Agent Dan Alcorn.
Medicare Advantage plans – also known as Plan C – and prescription plans – Part D – are available to individuals at age 65 and who have contributed to Medicare through 40 quarters of qualified employment. The national insurers offering these plans are names we all recognize, Aetna, BlueShield, Humana and UnitedHealthcare, for example, but Alcorn said there are local carriers, as well.
“Not all plans are alike,” said Alcorn. “For example, a significant difference between HMO [health maintenance organization] and PPO [preferred provider organization] plans has to do with access to local, regional or national network of provider care.”
Alcorn said identifying which providers are contracted, “in network,” with which Medicare Advantage plan is pretty straightforward. He finds, however, it is the prescription drug plans where clients are most often surprised. With drug formularies, deductible and tier levels differing from plan to plan, clients with numerous or brand name medications need additional guidance so as to “minimize unpleasant surprises like the dreaded ‘donut hole.’”
As with most every business, serving prospective Medicare enrollees poses new challenges this year due to the pandemic, said Alcorn. Seniors are staying home due to the ongoing concern of COVID-19 exposure, which means Alcorn and his agent advisors have learned to embrace video technology and remote signature in order to serve their clients.
“During the Annual Enrollment Period, clients want to learn about the 2021 Medicare plans,” said Alcorn. “Home visits remain an option, but some people may be wary of having our agent advisor come into their home due to COVID-19. So, we now offer virtual and telephonic appointments. We’ve also had a number of front porch enrollment appointments where our agent advisors are wearing masks and practicing social distancing.”
Alcorn said some Medicare enrollees have deferred routine exams and screenings due to doctor offices not fully open this year or concern about public places in general.
“Many [Medicare] carriers are reducing or eliminating their co-pays, so that plan members can get their preventative care and screenings,” said Alcorn. “It’s very important that beneficiaries get their preventative care done on time, so they don’t have greater health problems later on. The carriers and providers have stepped up with reduced or no copays and promoted telemedicine, too. Perfect? No, but it’s a start.”
DGAlcorn & Associates are scheduling Medicare 101 webinars, virtual presentations and appointments through its website, www.dgalcorn.com. Alcorn encourages all Medicare enrollees to explore their options for 2021 during the open enrollment period.
“I look at each of these individuals as if they were my own parents navigating this system. I want to make sure the plan they choose is closely matched to their doctors, their prescriptions, their travel plans and budget.” said Alcorn.