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SALT LAKE CITY — As Medicare's annual enrollment period from Oct. 15 to Dec. 7 is approaching, recipients are being bombarded with calls and mailers attempting to persuade them to switch plans.
The annual enrollment period is coming after the United States on Tuesday named the first 10 drugs for Medicare price negotiations, which will go into effect in September.
"(Older adults) get a lot of people calling, commercials, mailers — a lot of people soliciting them, compliantly (and) non-compliantly, for further information, to try and get them to switch plans," said Angela Olson, an independent Medicare agent with Insurance Solutions.
The main concern for the older adults receiving these contacts is whether they can or should switch their plans in the first place, which Olson said is often only solicited for money-making purposes on behalf of the agencies reaching out. She helps Medicare recipients make decisions about their Medicare coverage.
Medicare is a federal health insurance coverage option for Americans over age 65 that is handled by the U.S. Social Security Administration. It covers most, but not all of the costs for approved health care services and supplies that are medical necessities, according to medicare.gov.
Medicare Part A includes hospital, inpatient and home health care coverage, and Part B is supplemental medical insurance to cover doctor visits and outpatient services. Part B often requires a monthly premium and regular copays. Part C, often called Medicare Advantage Plans, is a private insurance option for hospital and other medical coverage, which is offered as an option instead of A and B. Part D covers prescription drug costs and is optional.
Generally, a person only needs to sign up for Part A and Part B once. But, each year, it is possible to choose which way you get your health coverage (and add or switch drug coverage). Medicare is different from private insurance — it doesn't offer plans for couples or families and spouses can select different options, the federal agency states online.
It can be difficult to navigate complex health care coverage on one's own, especially when multiple companies are vying for the kickbacks.
So, what can recipients of the many attempts for information do? A local independent agent, like Olson, is a no-cost solution that can help. Independent agents make their money from the health carriers to which they refer people. Olson said good agents are willing to lose money if their client is already on the best plan without switching.
Dr. Joey Mattingly, formerly an adviser for the U.S. Centers for Medicare and Medicaid Services, told KSL.com that an independent agent is an excellent resource for help saving money on Medicare, adding that talking to family and friends or your local pharmacist about your options is a good asset, as well.
Finding a good agent, however, can be difficult — but it is not impossible. Websites that seek to guide Medicare recipients in the right direction include a site that Olson is still developing (findmymedicareagent.com) and hopes to have up by the opening of the upcoming annual enrollment period on Oct. 15.
In his advisory role with the Centers for Medicare and Medicaid Services, Mattingly helped with the implementation of the drug price negotiation program in its beginning stages. He said the negotiation will help users of those first 10 prescription drugs save money, but only covers those 10 out of thousands of drugs that are available.
"It may not have a huge impact on a lot of seniors," Mattingly said.
With nearly 56 million adults over 65 years old in America, President Joe Biden has said the negotiations will help up to 9 million save almost $6,500 on average.
Because the affected population is in the minority, looking into the best Medicare plan is important for healthy finances. "It's a bigger discussion than just your health," Mattingly told KSL.com.
Olson said just 2% of people are eligible for many of the advertised Medicare plans, emphasizing the need to get outside opinions on making decisions when it comes to keeping or switching plans.
Among the calls and mailers older adults receive, Utah's Department of Health and Human Services warned Wednesday to be aware of phone scams targeting "Utah's elderly population."
"Often, the caller impersonates an employee of the Utah Department of Health and Human Services. The caller then tries to collect personal information from individuals, such as Social Security number, Medicare number, age and full name. They may try to sell products or services. DHHS employees will never call to promote services or products for sale," the department warned.
For more information, visit usa.gov/medicare.
