Question: I got a letter in the mail saying my insurance coverage will be with a new company this year. I didn’t change plans, so why did that happen? Should I change my drug plan? Does my supplemental insurance need to change as well?

Answer: It sounds like you have Original Medicare, a Medicare Supplement Plan (Medigap) and a Stand Alone Drug Plan. In this situation, your Original Medicare and your Medigap will continue to “stay the same” unless you want to change your Medigap. You understand that your Medicare Part B premium may change, but your COLA (Cost Of Living Adjustment) to your Social Security will cover that change. Your Medigap plan premium might change as well. The insurance company has mailed you information about “proposed” changes. This usually means your monthly Medigap premium will probably increase.

Your actual Medigap coverage will not change unless you choose a different plan altogether (example; switch from Plan C to Plan N).

The plan that usually changes the most year to year would be your Prescription Drug Plan (PDP). This PDP can change each year in any one of several ways. This year one of the most common changes, is a name change. Other changes can include a premium increase or decrease the plan charges you each month; the medication coverage may be more or less comprehensive; deductibles and co-pays may be different; and the “in network” or “out of network” pharmacies may also change.

There were 23 PDPs available in 2019, and in 2020 there are 27 PDPs.

The plans that have changed names can make this confusing because you are getting material from a plan you don’t recognize, and two of the new plans have names from previous plans. These are EnvisionRxPlus from 2019 is now EnvisionRxSecure for 2020 and costs $37.50 per month. The company introduced a new plan for 2020 called EnvisionRxPlus for $13.70.

The average premium for all the plans in New York state is $36.55 per month, and that is almost $3 lower than last year. The minimum coverage allows for a $435 deductible. Once you have met the deductible you are in the initial coverage stage. The initial coverage period lasts (and the coverage gap begins) when $4,020 in total drug costs has been spent. Your medication would need on average to cost more than $335 per month to hit the Coverage Gap before the end of 2020. The Total Drug Costs means not only what you pay but what the medication costs according to your insurance and your pharmacy. Once you hit $4,020 in total drug cost, you enter the Coverage Gap. Your cost during the Coverage Gap for 2020 has gone down and is 25% for both Brand Name Medications and for Generic Medications to you.

There are 14 plans that increased their premiums, and six that have lowered premiums. The cost of your medications will also change. The way your medications are placed in tiers, and what those tiers cost you each year may change. If you take very little medication or no medication, there may be a cheaper option this year. But review your choices available using some of the tools out there. The least expensive plan premium this year is a new plan at $13.20. With the next closest to that lowest monthly premium being $13.70 and $14.20.

The information on the new 2020 plans is available via the medicare.gov website, as well as (800) medicare. These are both available 24 hours a day, seven days a week between Oct. 15 and Dec. 7.

You also have agencies and programs that are available locally to help you find new insurance. There is Office For the Aging 661-8940 or 753-4471 staff available to help with insurance questions throughout the year. Southwestern Independent Living Center 661-3010 also has staff available to help with insurance issues. The insurance companies themselves and local Brokers are also available to help you make your decisions.

Don’t panic, you have until Dec. 7 to make a different choice.

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