Average 2018 Premiums Are Lower

Question: I just received a letter from my insurance company reviewing what happens in 2018 with my insurance coverage. The price went down. Is that normal? What should I do?

Answer: I have started to hear from a number of people that have started to receive their Annual Notice of Change from their insurance company. This letter is a required notification they must send to every individual to describe the insurance coverage in the New Year (2108). Medicare Part D Prescription Drug Plans (PDP’s) and Medicare Advantage Plans (MA) are required to deliver that ANOC letter to you before 9-30-17. Some insurance companies mail them out weeks before that. Some insurance companies stick right to that 9-30-17 required date.

This ANOC packet includes information regarding current coverage (2017) and then next year’s coverage (2018). Usually the most important information is on the first or second page of the booklet/packet.

When these packets arrive, I begin to hear from clients letting me know what they say and asking questions about what to do. At this point we are half and half. What I mean by that is for those individuals who I have talked with, half of the Part D plans have raised the premiums and half of the Part D plans have lowered the premiums.

Now remember that the premium you pay to the insurance company is only a small piece of the entire puzzle. The deductible may have changed. The co-pays and tiers of the medications may have changed. The pricing structure at your pharmacy may have changed.

Each year some of those changes are dictated by Centers for Medicare & Medicaid Services (CMS), and some are decisions of the individual plans. The CMS standard Medicare Part D plan allows for a $405 deductible, the initial coverage phase lasts until your total drugs costs reach $3750. The next phase is the Coverage Gap (“Donut Hole”). This year Brand Name Medications will cost 35 percent and Generic Medications will be 44 percent of the total cost. The Catastrophic Coverage continues to be not more than 5 percent or $3.35 for generic medications and $8.35 for all others.

Remember that each Insurance Plan classifies medications into ‘Tiers.’ The medications you take can be the same, but the Tier they are assigned to can change year to year. So review that packet to see if the medications you take are still on the same tier.

If you have a Medicare Advantage Plan your insurance will still mail you an ANOC, but it will include much more information. It will cover the monthly premium for the plan, the Part D prescription drug benefit AND the Health Insurance co-pay structures. So there are a lot more changes that can be made to the plan.

Your Medicare Advantage Plan may still have a $0 monthly premium, but the amount you pay at providers and for medical procedures can change. The Prescription Drug Benefit will also change.

Now you see why I get so excited about the Oct. 1 information! There is so much new and exciting information to review! That ANOC letter and packet of information you have just received has a lot of useful information you should review. After reviewing the numbers and information, you can make your decision to change your insurance or not. If you want to change your insurance you would have that Oct. 15 to Dec. 7 timeframe to make that change. You have 53 days to make any changes you would like to make to your insurance products. If you decide to keep the plan you currently have you most likely don’t have to do anything. It will just continue to cover you in the 2018 calendar year.

If you decide that you don’t want your plan and would like to make a change that Oct. 15 to Dec. 7 is the time to make that change. Don’t put it off, the time goes quickly.

Last year you may remember we had a LOT of changes to the plans offered. There were a number of plans that were no longer offered, and many people HAD to make a different decision. We are all hoping that does not happen again this year. That was very stressful. I will say the average premiums for 2018 indicate a reduction in premium costs. Now that does not mean all premiums went down, that means the average premium is lower. You need to review the information from your plan to make the appropriate decision for you.

Happy Insurance Season (a little early)!!

To contact Janell Sluga, GCMC with questions or concerns, please call 720-9797 or e-mail her at janells@lutheran-jamestown.org.