We get this question of switching from plan to plan on a regular basis, especially with folks that develop insulin dependency.

Gordon has been our client for years and called one day out of the blue with a big question. He had developed insulin-dependent diabetes and his co-pays on his current Medicare Advantage plan were awfully expensive for the insulin quick-pens he wanted to use. He first wanted to know if he could switch to a Medicare Medigap (Supplement) with a Part D drug plan. I reminded him that he cannot switch to a Medicare Medigap if he has a permanent chronic condition. “Well, then, what are my options,” he asked?

If an individual develops a permanent insulin dependency, they can then make a switch to a Medicare Advantage Special Needs Plan (SNP) the very next month! These are not offered by all carriers.

After reviewing all available plan options, we found a Medicare Advantage SNP plan that offered $0 co-pay for diabetic supplies and had only a $9 co-pay for his insulin pens. Gordon could not believe the difference in the benefits of the new Medicare Advantage (SNP) plan vs. the Medicare Advantage plan he was currently enrolled in.

We explained that not all Advantage plans are the same. This is exactly why you should shop for plans every Annual Election Period from October 15th to December 7th, with your new plan starting January 1st of the new year.

Gordon was a bit ecstatic when he saw that his co-pay for his insulin pens was going to drop from $69 to only $9 and his diabetic supplies were at no co-pay. The other benefit was that this new SNP plan also assigned Gordon to his very own diabetic specialist to work in concert with his Primary Care Doctor. Keep in mind that these Medicare Advantage SNP plans are not available in every county across the U.S.

Some Advantage plans cover hearing aids, some cover dental, some offer pick-up service to take you to your doctor’s appointment if you cannot drive, some offer paying for glasses, etc., etc., etc. Not all Medicare Advantage plans are created equal. It’s up to you, the consumer, to choose. And oh, by the way, there are 56 Medicare Advantage plans to compare in Maricopa County alone. Would you like a Fairy Godmother or Godfather helping you shop and compare?

 

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