The Three Ps of Medicare

By Beth Newcomb

This year’s enrollment period for Medicare launches on Thursday, October 15, and ends on Monday, December 7. In theory this might seem like a lot of time to make sure the plan you’re enrolling in is the best fit for your needs, but in practice it really isn’t.

“The Medicare annual enrollment period is the time when everyone who has Medicare either continues into the next year with their current plan, or they decide to switch to a plan that better meets their changing needs,” says Carl Lishing, a licensed insurance agent with HealthMarkets Insurance Agency and the recipient of the 2020 Best of Cleveland award in the insurance category. “They want to meet with a HealthMarkets agent to review where they are now, whether or not there have been changes to their current plan, and if switching to a different plan might better suit their needs in the coming year.”

With only so many hours available in the day, it’s important for you to schedule time to meet with Carl now.

“It’s not a requirement to meet with me, but why wouldn’t you take advantage of my free guidance?” he asks. “I spend hours reviewing all of the changes to Medicare plans, so instead of having to dig through a pile of information trying to decide if your plan has changed for the better or worse, or if there is another plan out there that might be better suited to your current situation, you can sit down with me and have that answer in about 30 minutes or less. It’s the smartest half-hour investment you’ll make.”

Carl has created a list of the three crucial areas to consider before enrolling in any Medicare plan.

Prescriptions
Perhaps the most important aspect to consider, taking a close look at which medications you’re taking, which medications you might need to start taking, or which medications you’re going to stop taking in the coming year is key.

Another thing to note is that the formulary list for the Medicare Advantage plan you’re on could be changing for the coming year. You’ll want to be certain your medications will still be covered and find out how much they’re going to cost.

Providers
“Provider lists tend to stay pretty stable from year to year,” Carl says. “So, while it’s important to review, there aren’t likely to be any major changes. But what you might want to consider on the provider side of a Medicare plan is whether or not a specialist you’ll be seeing this year is on the list. For example, if you’re going to be getting cataract surgery, you’ll want to make sure the doctor performing the surgery is on the list. Or, if you’re going to be seeing a cardiologist, the same idea applies.”

Plan Design
You’ve reviewed the prescription coverage and the provider list, now it’s time to consider the rest of the way the plan you’re considering is designed. “There are sweet spots to find in each plan and they differ from one to the next,” Carl says.

The co-pay is another area that might vary from plan to plan, and you need to decide if that’s an expense that makes sense for your situation. Some plans don’t have a co-pay, but they might cost more. Northeast Ohio is fortunate to have a variety of plans, like Medical Mutual, available.

“There are a lot of variables,” Carl says. “Some people need a plan with dental and vision built in, others might elect to pay for those separately. Reviewing the design of a plan is an important part of making your decision.”

Navigating the ANOC
Everyone currently on Medicare will get an Annual Notice of Change (ANOC). Carl says this important piece of information contains everything you need to know about what your Medicare plan will look like in the coming year, and if there are any changes. He can help you decipher exactly what this notice says and how it applies to you.

“In some cases, it will make sense for a person to stay put on their current plan. Others may want to consider switching,” Carl notes. “I’ll help you determine which option is right for you, and the best part is my guidance is always free of charge.”

Meet Carl
Carl lives in the Edgewater area with his wife and three kids. He’s been married for 21 years and spends as much of his free time as possible on Lake Erie.

“Helping people is the best part of my job,” he smiles. “I get a lot of satisfaction from doing the right thing for them.”

Licensed insurance agent Carl Lishing’s consultative, problem-solving approach has garnered him the Best of Cleveland Award in the insurance agent category. You can reach him at 216-228-0765. HealthMarkets Insurance Agency is located at 16506 Detroit Avenue, in Lakewood. Office hours currently by appointment. Find out more at ClevelandInsurance.info.

HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and the District of Columbia. Not all agents are licensed to sell all products. Service and product availability varies by state. Agents may be compensated based on enrollment. No obligation to enroll. 46383-HM-1020