• MEDICARE 2019

    The information below is for CURRENT Medicare clients. NEW Medicare clients should contact our
    office for an appointment to discuss options.

    I’ve heard some Medicare Health Plans are closing at the end of the year. Does this affect everyone?

    No. UCare and Humana medical plans are not impacted as they are Medicare Advantage plans. The
    BCBS Senior Gold plan is also not impacted as it is a Medicare Supplement plan. Clients on these plans
    will experience their typical renewal.

    What plans are being closed at the end of the year?

    The following plans will close in most metro counties and many outside the metro area: BCBS Platinum
    Blue, HealthPartners Freedom and Medica Prime Solutions. These are called COST plans; and they must
    close and transition into ADVANTAGE plans for 2019 due to federal law.

    What plans will be available in 2019 if Medicare COST plans will close?

    BCBS, HealthPartners and Medica will offer Medicare ADVANTAGE and SUPPLEMENT plans in 2019. You
    will be allowed to enter any plan during the annual enrollment period (10/15 – 12/07). There are also
    other Advantage and/or Supplement plans available by UCare, Humana, UHC/AARP, Cigna, Aetna etc.

    What do I need to do during the Annual Open Enrollment to have a plan for 2019?

    If your medical and drug plans are with the SAME insurer, you should have an AUTOMATIC
    ENROLLMENT offer into your insurer’s Advantage plan. You should review the plan offer (just as in past
    years) and if you do nothing, you will continue with your current insurer on their ADVANTAGE plan.


    If your medical and drug plan is with a DIFFERENT insurer, you will receive an ADVANTAGE plan offer
    from your medical insurer. HOWEVER, you will most likely need to contact them by phone or
    electronically to sign up for that plan. Please read their instructions this fall.

    In looking at my 2019 offer, what should I review to be sure the plan is right for me?

    The network of clinics/hospitals! Be sure to check the network for the Advantage plan to make sure
    your clinics are in-network. Cost plans have had minimal networks. Advantage plans WILL have some
    clinics/hospitals covered in their plan (and some will not…meaning no insurance coverage).


    You should also look at co-pays, co-insurance and the out-of-pocket maximums. Finally, be sure to look
    at the drug coverage for any changes.

    What if I don’t like the Advantage plan offer – or – what if my clinic is not in-network or my drugs are
    not covered?

    Be sure to let me know the non-network clinic name, drug issue or concern with the Advantage plan. I
    will be happy to make a recommendation to another plan and help you with the paperwork.

    My insurer gave me a few choices – Advantage and Supplement. What are the differences?

    The Advantage plans will be the automatic offer since it will be “deemed equivalent” to you current Cost
    plan. These plans have co-pays or co-insurance for most services (with no or a small deductible) and will
    include a drug plan. They will have a network of clinics or hospitals that you must use for coverage.
    They will also have a variety of levels of coverage and premium. You may change these plans yearly to
    go up and down in coverage with no health underwriting.


    The Supplement plans allow you to go anywhere that accepts Medicare so they generally have a wider
    network of hospitals/clinics. Many plans offer full coverage with no co-pays. These plans may be more
    expensive or have higher deductibles (compared to Advantage plans). These plans only open on
    occasion so you may or may not be able to purchase one in the future. However, all Supplements are
    available to those losing Cost plan this fall for a Jan. 1 effective date. You will need to purchase a
    separate drug plan with a Supplement.


    In a nutshell, you should think carefully about how comfortable you are with a network of
    clinics/hospitals compared to premium and co-pays/deductibles.

    In the past, my agent has assisted me with choosing a plan. Will you be able to help this year?

    Yes! We will be making recommendations on a first-come, first-served basis. Due to the volume of
    changes this year, we do expect our service time to be slower than usual. We may not be able to sit
    down with each client, but we will give recommendations to all.

    Is there anything I can do now?

    Feel free to email your important clinic names and any other concerns to:
    meganh@thecriterionagency.com