Did you or the broker you work with use the Plan Finder Tool to find a lower cost drug plan for 2020?
If the results of the plan finder tool do not match up with your medication fill/refill costs you should have a 2nd chance to change plans for 2020. CMS should be making an announcement on this soon.
What is the issue? The tool produced inaccurate results that beneficiaries, brokers and others that help Medicare beneficiaries make sound decisions to changing prescription drug plans.
It is imperative you read the articles found here and here and here to learn your options for 2020. You may have a ‘special enrollment period’ to change plans.
Should you Change Medicare Prescription Drug plans?
If you are spending more than a few hundred dollars on your annual out of pocket cost for prescription medications (this means your actual refill cost added to your plan’s premium), we recommend you evaluate your alternatives between October 15 and December 7th each year. These plans can change noticeably every year and is an easy way for insurance companies to raise revenue. We can help you get this done.
We feel Idaho residents should change Medicare prescription drug plans when they can get better value by doing so. Plans change annually; if you don’t pay attention to these changes and compare your options annually , we feel you may be setting yourself up for higher costs and frustration.
We have noticed the annual cost for the same set of medications can vary by over 300% between Medicare prescription drug plans available in Idaho.
This is true for people with Original Medicare (with or without a Medigap plan) and Medicare Part C (Medicare Advantage).
We feel Idaho residents should be paying close attention to the prescription drug cost side of their Medicare Advantage plans, especially if they are paying more than a few hundred dollars per year on medications. If you have a Medicare Advantage Prescription Drug plan and find a different plan with lower drug cost and can continue to use the same doctors and other providers (and maybe include more choices) and health cost copays/coinsurance are similar, consider changing plans to save the money.
There are over 20 plans available to people that stay with Original Medicare with or without a Medigap plan. Take the time to understand the differences between your choices. You will be surprised to see the differences between your annual out of pocket costs between these plans.
There are attractive lower premium Medicare Advantage plans available.
If you are paying more than $70 a month for a Idaho Medicare Advantage plan it is time you compare your existing plan to your alternatives. There has been a growth in low/$0 premium Medicare Advantage plans in the past few years which compare well to the older higher premium plans. Ask for a review between 10/15 and 12/7 OR 1/1 and 3/31.These are your 2 annual windows to change plans.
Most Idaho Counties have good alternatives to high-premium ($70+/month) Idaho Medicare Advantage (MA) plans.
If you live in an Idaho County with 5 (or more) plans with premiums below $70, we encourage you to review your options.
A caveat when reviewing plans with lower premiums, exclude those which do not include prescription drug coverage (these plans are for Veterans that get their med’s from the VA AND plans reserved for residents eligible for Medicare Medicaid Coordinated plans (MMCP).
When should you review plans?
Between 10/1 thru 12/7 AND 1/1 thru 3/31 every 2 – 3 years.
Why every 2 – 3 years?
Because new plans can come to market and the details of existing plans change annually. Be aware the details of each plan can change at their own rate; some insurance companies are simply more aggressive about taking market share from other companies; they do this by offering higher value plans at a lower cost to the Idaho Medicare beneficiary.
If you are uncomfortable with this task, work with a Idaho based broker that is licensed with all/most all plans available in your County. How do you find out? Ask them which plans they are NOT licensed with. Check out what plans we are/are not licensed with here. Call us if you would like help.
Why do this?
If you look at the higher premium Medicare Advantage plans available in Idaho, they may have been the initial plans available from that particular insurance company when they got in the Idaho Medicare Advantage plan business. In our opinion, these same plans do not compare well to some of the plans this same company introduced to the Idaho market in the past 5-years. Often the newer plans have lower premiums, the same or lower out of pocket costs (for most covered services) and the value of ‘extras’ in the newer plans can benefit the shopper. Of course, your out of pocket cost for covered prescription medications will be part of any plan change decision.
What is really important when considering a plan change.
The doctors/hospitals you wish to get care from are in the plan’s network.
Make sure you have access to Hospitals with a 4 or a 5 Medicare star rating. We suggest avoiding facilities with no rating or a rating below 3-stars. Check current hospital star ratings here. When this web page appears, check off ‘hospitals’; when this page refreshes, enter your zip code and the radius around the zip code you want to search. If hospitals outside of Idaho appear in the list, be aware they may not be in any Medicare Advantage plans you are considering. By the way, this same tool is very useful finding doctors/other providers that ‘accept Medicare insurance’ anywhere in the US.
If you are considering a PPO plan, be aware if you go out of network, the provider you may want to work with may choose to NOT accept your plan’s terms. This means you need to keep looking for another hospital/provider. This language is contained in each plan’s ‘Evidence of Coverage’ document. If you have an HMO plan and wish to use the services of an out of network provider (and you do not have agreement with your insurance company to go out of network AND they will help you pay for the services received) you will pay retail for any services received. Also be aware the Mayo Clinic(s) do not accept Medicare Advantage plans available to Idaho residents. Read their announcement here. Another issue to be aware of is a Medicare Advantage plan’s network of doctors/hospitals can change during the year. An example of this is found in this article.
Review the plan’s cost for services received AND the plan’s ‘Maximum out of pocket limit’ (MOOP). We recommend adding the plan which has the lowest MOOP to the ‘short list’. Be sure and look at the number of days the ‘skilled nursing care’ copay is in place. The plan(s) with the fewest days this copay is in place should also be on your short list.
Look at the details of the plan’s ‘extras’ (services not covered by Medicare). These can vary widely between plans. Separate these ‘extras’ into 2 classifications – those you will use and the ‘nice to have’ but may not use. Place emphasis on those you will use and compare the details of the differences.
We can do this for you if you prefer to work an Idaho based broker.
Are there other more flexible plans available?
Yes. Medicare Supplement (also known as Medigap) plans are available to Idaho residents.
There are 12 different plans; they are offered by private insurance companies. Each of these plans pickup a different combination of the costs that Medicare does not completely cover.
We like this plan type because you have access to any doctor/hospital/other provider in the US that ‘accepts Medicare insurance’. This means the top 50, 100 and 250 hospitals are available to you…including the Mayo Clinics.
Some of these plans pay for most/all of the left over costs that Part A and B do not completely pay for. To us, this means you can budget with confidence for your Medicare covered health care services and you have access to the top physicians/hospitals (provided they ‘accept Medicare’….most do.
We feel a Doctor of Internal Medicine is an excellent choice for a primary care physician. Why? Because the go to school for 2 extra years to recognize and treat health issues of people 55 and over.
A Doctor of Internal Medicine specializes in diagnosing health issues of people 55 and over.
Stated another way “Doctors who practice internal medicine specialize in diagnosing, treating, and preventing disease in adult patients. Like other primary care physicians, internal medicine physicians are the first doctors their patients see when they are sick or injured. They can also refer their patients to other specialists when necessary.”
They are required to take additional education on this topic.
Some Doctors further specialize in geriatric medicine.
If you are 65 or older, we recommend you consider selecting a Doctor of Internal Medicine. If you are a resident of Ada/Canyon County, you can find physicians with the geriatric specialization by clicking here. Internists in Ada/Canyon County can be found by clicking here. If you are a resident of another Idaho County, just adjust the search zip code and re-run the scan.
We feel the answer to this question: Should I get my Medicare services from a Doctor of Internal Medicine is ‘yes’.
It is not unusual for Medicare beneficiaries new to Idaho ask us for a doctor recommendation. We ask if their current doctor specialized in internal medicine…and most often the answer is ‘no’. Once we share with people that internists had special study and training on the prevention and treatment of adult diseases, they get interested.
A key item to remember about internists is they are often the doctor for doctors. Why? Because they are called on to act as consultants to other physicians and help solve challenging health issues. Have you seen the TV show ‘House’? He was a doctor of internal medicine. However, the internists we are familiar with are much easier to work with.
We recommend Idaho residents not focus on this Medigap Plan
Why don’t we recommend Medigap Plan L? Because the plan has limited Idaho and National enrollment.
We feel there are better choices for people that prefer a Medigap plan.
Why is limited enrollment in a Medigap Plan across the Nation an issue?
First, what is ‘limited enrollment’? According to the Mark Farrah report dated 5/29/2020 (foundhere) the national enrollment in Plan L combined with Plan K had 1% of the Medigap market in the US through 12/31/2019. This is the lowest national enrollment in any Medigap plans currently available. The insurance company with the largest Medigap market share included Plan L in their Medigap plan portfolio. Their marketing muscle is still having a challenging time moving the needle on this plan.
Interested in Medigap Plan K? We recommend Idaho residents consider Plan F Hi-deductible, Plan N or Plan G .
People refer to Medigap Plan K by these other names: Medicare Plan K, Medicare Part K, Part K and Plan K. If you hear others mention these words, they are referring to Medigap Plan K.
If you are not a resident of Idaho (or planning on moving to Idaho in the near future) be aware that all Medigap policies must follow Federal and state laws that protect people with Medicare.
Call your State Health Insurance Assistance Program (SHIP) or your State Insurance Department for more information; ask how your state may have implemented laws affecting Medigap plans.
Minnesota, Massachusetts, and Wisconsin are waiver states. This means they:
Provide different kinds of Medigap policies NOT labeled with letters
Provide comparable benefits to standardized plans
Have a different system that includes basic (“core”) and optional (“rider”) benefits
Medigap Plan K is NOT on our recommended list of Medigap plans for Idaho residents.
Why? Because:
the plan has limited Idaho and National enrollment (although this is growing) and we feel there are better choices for people wanting a Medigap plan. Medigap Plan G, and Plan N are on our Medigap plan recommended list (Plan A, B, D in select situations) are more than suitable alternatives for Medigap Plan K.
What you need to know when considering a change to Medicare Advantage Plans
Should you change Medicare Advantage plans? There is a defined process for doing this. If you are a resident of Idaho, call us. We are here to help.
Should you change Medicare Advantage plans?
Maybe. We feel you should ask this question each year between October 15 AND March 31.
Why? Because some of these plans continue add coverages at little or no cost to the plan member. If these coverages add value to you and your choice of doctors/hospitals/other providers remains the same and the out of pocket cost to use plan services is lower/the same as your current plan you may be better off to change plans.
If you relate to points below you may be better off if you change Medicare Advantage plans.
The points to consider are:
1. Your monthly premium is above $70 and you are concerned about your copays and ‘out of pocket limit’ rising each year.
2. You learned other plans have much lower cost for the prescription medications you take.
3. You moved to a zero premium plan and later found out the plan only has one major hospital in it’s network and your selection of physicians is much smaller than you thought.
4. Not all of your medications are covered by your plan.
5. You learned other Medicare Advantage plans that now include preventive and comprehensive dental included in the plan’s monthly premium and yours does not.
6. Your current plan requires permission to see a specialist. You want a plan without this requirement.
7. You know the government no longer gives insurance companies with a star rating below 4 any bonus money and are concerned your premium and copays are higher because of your plan’s 3 or 3.5 star rating.
8. Your plan will not be available next year (you will get a notice from your insurance company if this happens to you).
9. The doctors and/or hospitals you prefer are no longer in your plan’s network.
10. You did not really explore your options before enrolling in a Medicare Advantage plan. You just enrolled in a plan your neighbor, friend, or was offered by your group insurance carrier before retiring.
11. You did not know about or understand your options with the 10 different Medigap (Medicare Supplement) plans.
12. You didn’t understand that with Original Medicare you can use any doctor/hospital that accepts Medicare and you are feeling the network restrictions of your Medicare Advantage plan is limiting your provider choices.
13. Your Medicare Advantage plan has extra features not covered by Medicare and you are not using them. You are concerned your premium is higher because of these features.
14. You just learned about 2 Medigap plans with an out of pocket limit much lower that your Medicare Advantage plan AND these plans let you use any doctor/hospital in the US that accepts Medicare.
15. You feel it is unfair to have to be restricted on you choice of doctors and hospitals.
16. You just learned about the article found here and are wondering if you made the right choice.
What should you do? Should you change Medicare Advangtage plans?
We recommend Idaho residents avoid Medigap Plan M. You might consider Plan N or Plan G. Call us if you have questions.
Medigap Plan M is NOT on our recommended list of Medigap plans for Idaho residents. Why? Because the plan has limited Idaho and National enrollment, few insurance companies in Idaho offer this plan, and we feel there is much better value available in other Medigap plans.
If you are moving to Idaho and need help with Medicare insurance, note we are licensed with all plans available in all 44 Counties and will explain their differences, answer your questions, and help you enroll in the plan you choose.
Idaho residents are fortunate to have six different hospitals with a 5-star rating (by CMS). Over 4700 hospitals in the US have star ratings and 407 attained the 5-star rating.
The Idaho hospitals with a 5-star rating are located in Boise, Gooding, Ketchum, Idaho Falls, Pocatello, and Twin Falls. Learn more about these ratings and specific hospitals here.
We suggest you ask your current physician(s) to refer you to physician in the same specialty that accepts Medicare and help you get your initial appointment. Be sure and get a copy of your medical records before your move.
If you are not presently using a ‘Doctor of Internal Medicine’ (learn more here) as your primary care physician, we suggest you consider doing this when you get established in Idaho
If you need to find a physician before you move, use the tool found here. This is an easy way to find doctors by specialty within zip code any where in the USA. Once you develop a short list of physicians to consider, we suggest you use this tool to learn how others rated each.
We will help you find the Medicare Advantage plan that meets your needs and budget.
We are seeing the Idaho market for Medicare Advantage plans get far more competitive. There are some lower population counties with no to few Medicare Advantage plans. Some other counties have multiple plans available with good provider networks. Counties with the largest population of Medicare beneficiaries (Ada, Canyon, Twin Falls, Bonneville, Bannock, Kootenai, etc.) have more plans to choose from.
If you plan to move to an Idaho county without any choices for an MA/MAPD plan, you can stay with Original Medicare. We encourage you to consider adding a Medigap plan to Original Medicare. At a minimum, consider enrolling in a Plan G Hi-deductible or a F Hi-deductible. If you want a plan that pays all/most all of your share of the left over costs that Part A and B do not completely pay for, consider a Plan F (enrollment restrictions apply) or a Plan G. Learn more about Idaho Medigap plans and carrier differences here.
Important: You have a ‘Guaranteed Issue’ right to enroll in a Medigap plan
If you need a refresher on Medigap plans, please read pages 7 – 24 of the document found here. Some of these plans cover ALL or NEARLY ALL of your Medicare-covered health expenses AND you have a choice to use the services of any doctor/hospital in the United States that
Idaho residents can now change Medigap policies annually. In many situations this can be done without any underwriting. If you have had the same Medigap plan for more than 5-years there may be a top rated company offering your plan with a much lower rate. We have helped other Idaho residents find a better rate from a company with AM Best ratings of A- (better) and have a solid record in the Medigap business.
Maybe. In many situations, Idaho residents can change Medigap policies without going through underwriting.
Why would you want to do this? Because your current plan is available from another company at a meaningfully lower monthly premium. If there is another plan that better suits your needs and budget, you may be able to skip underwriting too. Check out the plan mapping resource found at the bottom of the web page found here. Enjoy the savings!
With Idaho’s move to ‘community rating’ and also implementing the ‘birthday rule’, this process is much easier. It is so easy, we recommend this be reviewed annually. Why? The premium savings can be meaningful. We have found changing your Medigap policy is much easier than changing your auto and home owners insurance.
If you can get you same plan from a different company at a meaningful lower premium, the savings are better in your pocket than an insurance company’s bank account.
Should I change Medigap policies annually?
We recommend this be considered.
Why? Because of the Idaho market place changes annually. New companies offering these products can enter the Idaho market with attention getting lower premiums. Existing companies can also request (and receive) annual premium increases. The amount of annual premium increases varies between companies. For example, in 2024 some Idaho companies had increases in the 10 – 20% range. A few were in the 6 – 9% range. Why the larger than normal increases? Claims were up in many cases, again from the deferral of getting health care issues resolved that were put off during the covid era.
With the Idaho law changes implemented on 3/1/2022, you now have the ability to move from one company to another and get the same plan without going through underwriting.
How does the Birthday Rule affect your right to change Medigap policies?
To take full advantage of this Idaho law change, you should change Medigap policies during the 63-day window that starts with your birthday. If you do this any other time during the year, you will have to answer the underwriting questions on the company’s application. Your application could be denied depending on your answers to these questions.
Some examples of how you may benefit if you change Medigap policies
You recently moved to Idaho and are already enrolled in a Plan F. The same policy is available in Idaho at less than $230.
You presently have a Medigap Plan F and have been considering switching to Plan G. Be aware the only difference between is Plan G does not cover the annual Part B deductible. This years Part B deductible figure is found here. This figure can change annually and is controlled by Medicare. The reason some people switch from Plan F to Plan G is the difference between the monthly premiums between the 2 plans. This difference, when annualized, is greater than the annual Part B deductible. This means Plan G offers a better value than Plan F. You can switch to Plan G for less than $195/month. If you need an update on Plan G, read this information and return to this page when done.
If your current Medigap plan N has a premium greater than $150, a lower premium is available from a quality company.
You are currently enrolled in Medigap Plan C or D and you have experienced many years of annual rate increases. It may make sense to consider a Plan N and pay some out of pocket costs when you see the doctor or visit the ER. You can do this without going through underwriting. If you can get through underwriting, it may make sense to consider a Plan G.
You presently are enrolled in one of the older Medigap plans (H, I, J, J-hi deductible) and want to move to one of the current plans.
Additional examples when you change Medigap policies
You are enrolled in Medigap Plan K or L and realize you are better off with a Plan N or G. If you can answer ‘no’ to the underwriting questions on a company’s applications, make the switch now.
You are enrolled in Medigap Plan M and realize you are better off with a Plan N. You can do this without going thru underwriting.
A select few companies include a gym membership in their plan(s). If this feature is important to you, switch to a company that includes this benefit. We recommend you be aware of all companies offering this feature before changing. Why? Because there is a noticeable difference in monthly premiums between companies including this feature.
The company you are presently with announced another annual rate increase that caught your attention. Now is time to evaluate your options. Keep in mind when you change companies, your new rate should not change for the 12 month period following the new policy effective date. Think about this point. This approach is important if you want to effectively manage your Medicare health care cost.
You may see some companies offering a ‘multiple household discount’. This means more than one person within the household has a Medigap plan with the same company. We recommend you always compare the ‘net premium’ to the premium of other companies offering the same plan. We have found other companies are offering the same plan at lower rates even after a household discount is considered. Don’t ‘buy the headline’…always check the math.
If I change Medigap policies what about customer service? Are these other companies reliable?
This is a question we often hear and is a natural concern. A survey conducted and published on 4/20/20 noted 94% of people with a Medigap plan are satisfied with their plan. Please take a moment and read the article found here.
We often see companies attempting to use customer service as a differentiator between your choices. They do this without mentioning the national average rating of all policy holders enrolled in a Medigap plan. We feel comfortable with customer service of the companies we recommend.
A process for evaluating insurance companies offering Medigap plans in Idaho
Below is the criteria we use to eliminate companies from our recommend list.
AM Best rating less than A-. There are some exceptions to this guideline. For example, if a company had a B+ rating for many years and continues to be successful/profitable in their line(s) of business we may consider them.
Has a Medical Loss Ratio more than 2 points above the national average for the past year. We also look the annual change in this ratio. It it has gone up 3 points or more year over year, it could be a ‘red’ flag.
Have less than 10,000 policies in force. If this is a national company marketing their products in multiple states, this can be an indicator of a lack of commitment to the Medigap line of business.
Have been in the Medigap insurance business less than 4 years. If the company is a subsidiary of another company that has been successful in the Medigap business for many years we may waive this consideration. Why? Because the parent company is typically running the Medigap business for the subsidiary. The parent company’s goal of adding their subsidiary in the same market (like Idaho) is simply to get more business.
Should an Idaho resident use a broker to help them change Medigap policies?
If Idaho residents wish to select and enroll in a Medigap policy on their own they can certainly do so. The information outlined above will help them navigate their way through the process.
If Idaho resident works with an broker that specializes in Medigap plans, much of this annual burden can be eliminated. Their broker should contact you 30-days before your birthday and review your options. If you choose to make a change, they can help you get this done. They will also help you review your prescription drug plan annually.
Brokers are compensated by the insurance company when their client enrolls in a plan. This is how the broker covers their overhead and can continue to provide this service. The person the broker is working with pays the same monthly premium whether they use a broker or not.
How does underwriting work if I change Medigap policies outside of my birthday window?
Every company’s Medigap application has a section of underwriting questions. If the person applying for a Medigap plan is not in their one-time open enrollment period, birthday window, or have a ‘guaranteed issue’ they answer these questions. The company can deny the application based on the answer to these questions. Be aware each company can have their own questions. Most all companies have the same core questions, but even these may vary. If an applicant is denied enrollment by one company, a different company may not ask the question(s) causing the denial. A broker can help with this.
Some companies have automated the underwriting process while others may require a telephone interview.
More information on the Idaho Law change that made this possible
The Idaho Department of Insurance did a great job of putting together a list of ‘frequently asked questions’ on this subject. Be sure and read this as they add more clarity to this important change. They are available here.
Call us if you are an resident of Idaho (or planning on moving here within 6-months)and want to change Medigap policies
We are located in Boise have been helping Idaho residents in all 44 Counties with Medigap plans since 2012. We are not here to sell you a Medigap plan. Rather we educate the people we work with so they can make the decision about specific plans and the company that is right for them. We help them enroll in the plan with the company they pick.
If you choose to use our services, we ask you to complete enrollment in your new plan with us. Our services are no cost to you.
This page was last modified on Jul 12, 2024 @ 4:14 PM
Medigap Plan C – is on our ‘proceed with caution’ list
We recommend Idaho residents avoid Medigap Plan C. Read more to learn why.
Is your Medicare Part A and B effective date 1/1/2020 or later?
Medigap Plan C and F are not available for people new to Medicare on/after January 1, 2020. This means if your Part A and B effective date (on your Medicare card) is 1/1/2020 or later you can no longer enroll in either of these 2 Medigap plans. This is a Federal law change.
What should you do? Consider Medigap Plan G. Learn more here.
Is your Part A or B effective date prior to 1/1/2020?
If yes, please review the enrollment guidelines for Medigap plans on pages 14 – 16 of the document found here. If you do not meet these requirements, learn if you have a ‘guaranteed issue’. Information on this topic is on pages 21 – 23 of the same document mentioned above.
If you want help understanding this information, call us.
Other important information about Medigap Plan C
Monthly Premiums for Plan C vary by over 200% between the companies offering this plan to Idaho residents
Check current monthly premiums for Medigap Plan C (and Plan G and the rest of the Medigap plans) here. Notice the rate tables are broken down by 5 year age differences and there is a separate table for people that use tobacco and those that do not.
Note Idaho is an ‘Issue Age’ state; this means each company has a monthly premium for each age and each plan they offer in Idaho. This also means the rate tables mentioned above will give you the rates at 5-year intervals. We can help you with specific rates for all ages.
Notice the monthly premium difference between Medigap Plan C and Plan G. When you annualize these rates the Plan G annual premium is still less than the Plan C annual premium. This is why many people favor Plan G over Plan C. You get the same coverage for a lower annual out of pocket cost.
Insurance Companies with the lowest monthly premiums
We have always been cautious about recommending an insurance company with the lowest monthly premium for any Medigap plan. The Federal Government published a report about Medigap premiums and what the characteristics of ‘outliers’ are (companies with above normal increases in monthly premiums). If you have an interest in learning about these findings please read this information.
Annual Medigap Plan C Rate changes
Remember, monthly premiums for all Medigap plans can change annually. Budget 7-9% and be pleased if it comes in lower. Personnel in the Idaho Department of Insurance review each company’s financials before approving any annual rate increase request. Applications for a specific rate increases can be denied if the financials do not justify the request.
Your initial monthly premium will not change for 12-months. Be aware if the company you choose has their annual rate increase during your initial 12 month rate guarantee period, you will feel the affect of the interim rate increase on day 1 of your 13th month you are with that company.
Who are the top rated Insurance companies offering Medigap Plan C?
Financial ratings and the trends of these ratings (going up or down) are monitored by financial rating firms. This is one of the factors we use to add company’s to our ‘recommend list’.
Medical loss ratios change from year to year too. These change both at the state and national level (national level includes all states the company offers Medigap plans). If a specific company’s ratio is 3 points above the national average for all companies offering Medigap policies (prior years figure) or goes up noticeably when compared to last year, a ‘red flag’ goes up. We keep track of this information. This is the 2nd of 8 factors we use to rate companies.
If you want help selecting an insurance company for your Plan C (or any of the other Medigap plans), call us. We will help you with this and enrollment in the company you choose.
We encourage Idaho residents to avoid these Medigap Plans
Medigap Plan K, Medigap Plan L, and Medigap Plan M are NOT on our list of ‘Medigap plans Idaho residents should consider’ because of their low levels of national enrollment. Total Idaho membership in plans K, L, and M is less than 2% of all Idaho Medigap enrollees. Nationally, these three plans had similar enrollment numbers. We encourage Idaho residents to avoid these plans.
Should you get your prescription drug plan and your Medigap plan from the same company?
It is easy to say yes to this question. However, there there is a process for selecting a prescription drug plan and we encourage you to consider the points below before you agree to enroll in any plan. These are:
if the plan covers all of the medications you take;
the plan’s Medicare star rating (learn more here); we do not recommend plans whose star rating is below 3 and prefer plans with at least a 3.5 star rating;
which pharmacies in the plan’s network offer the lowest fill/refill rates (pay attention to this);
if the plan offers a mail order pharmacy whose 90-day refill rates are lower than you going to the counter to get refills;
consider the plans meeting the above criteria that have the most medications in their own formulary; in 2020 the plans available to Idaho residents varies by over 900 medications in their respective formularies. This information is available here and was checked on 1/19/2020.
consider the 3 plans with the lowest annual out of pocket cost for the med’s you take and meet the above criteria; we encourage you to do this annually because insurance companies can and do change their plan details annually. These changes will affect your out of pocket cost.
We have noticed the annual cost for the same set of medications can vary by as much as 300% or more between prescription drug plans (PDP). If you do not compare your annual cost for a PDP before enrolling in a plan, you open up yourself to paying more for your medications. When you work with an independent agent that covers both Medigap and prescription drug plans, they should be able to help you find the insurance companies offering the lowest annual cost for the medications you take and have the pharmacies in their preferred network (they offer lower cost than ‘network pharmacies’) that are close to you.
If you want help selecting a prescription drug plan and are a resident of Idaho, call us.
Idaho residents interested in a Medigap Plan
Call us at (208)-867-0296 if you would like to learn more about Medicare Plan C coverage and benefits.
We are here to help.
This page was last modified on Jan 19, 2020 @ 6:25 PM
Would you like us to contact you between October 1 and December 1st to discuss new and updated Medicare Advantage plans that will be available on January 1 next year?
