What Just Happened to my
Part D or Advantage Plan?!?!
FAQ & Self Help Tools Below
Why am I making this Page?
To help us both prepare for an Open Enrollment unlike any other...
Due to many and historic changes, it is anticipated that call volumes will be at record levels for everyone in the business: Government and Non Profit Agencies, Agents and Brokers, Insurance Companies and Agencies and even Dr. Offices will all be affected.
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In addition, many Part D Plans will NOT PAY Agents and Brokers in 2025 for helping you like they have done in the past. As you might imagine, we have bills to pay just like you and everyone else. So this will be very challenging for all of us!
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As your current broker, I will always be there for you! However this year will be extremely busy for not only me, but the insurance companies and their systems I interact with as well. As a result, you may find "Helping Yourself" may be the quickest and easiest way to compare and enroll in a new Part D Prescription plan for 2025.
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Changes to Part D Coverage.
(Broad Brush Explanation & Official Links)
The Inflation Reduction Act (IRA) has greatly reduced the Out of Pocket Maximum for you & Increased the costs to the insurance companies. It has reduced the maximum you can pay from $8,000 to only $2,000 and also removed the dreaded "Donut hole".
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In short, your coverage got a lot better, but the insurance companies will pay a lot more in 2025 than previous years. This applies to both Stand Alone Part D Plans and Advantage Plans with Drug Coverage.
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The Premium Stabilization Demonstration Program was later offered to Part D insurance companies to limit their rate increases to no more than $35.
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If your rate went up more than $35, then the plan you are currently on likely got cancelled and the insurance company moved you to a different and more expensive plan.
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The Medicare Prescription Payment Plan is a new optional program designed to allow members to pay out of pocket prescription drug costs with monthly payments over the course of the plan year. Your insurance company for 2025 will provide you with information on how to enroll and how the plan works. They may even reach out to you if they believe you may benefit by it.
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If you are currently only taking cheap and/or generic drugs, this may not be for you.
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Medicare and You 2025 handbook
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FAQ - For Stand Alone Part D Plans.
I have a Supplement and a Stand Alone Drug Plan - What should I do?
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Look for and read your ANOC or Annual Notice of Change letter mailed to you by your current Part D Plan sometime in September. This is the full description of your current plan and the upcoming changes in 2025 to your premium and or coverage.
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(If you threw it out by mistake please call the member services number on the back of your card and request they resend it to you.)
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If you are happy with the changes and wish to keep the plan they are offering you then you can simply DO NOTHING and let it renew into the 2025 coverage and rates.
If you are with BCBSAZ or Mutual of Omaha and/or are being cancelled you will need to select and enroll in a new Part D Plan for 2025. ​​
If you are not happy with the changes then you will want to shop the new plan offerings and enroll through Medicare.gov, The insurance companies website or ask for help from our State Health insurance Program (SHIP).
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Why aren't you and many other brokers not selling Part D anymore?
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In addition to many new regulations that have increased the time and cost to sell these plans, many insurance companies no longer pay brokers a commission to help people enroll.
While selling insurance may be really fun, like everyone else, we need to be paid for our time and efforts to stay in business.
Self Help Tools
Pro Tip - KEEP IT SIMPLE! You only have 2 costs - One is the Premium to the insurance company and the other is the cost you pay for your Prescriptions.
So long as you can get the drugs you need at the pharmacies (or mail order) you want, then simply look at the least expensive plans by Combined Premium and Drug Costs, pick one and enroll.
It really is that simple! ​​
Medicare
Go to Medicare.gov to Shop and Enroll online.
(It's easier than you may think!)
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Call 1-800-Medicare for help by phone.
SHIP - AZ State Health Insurance Program
(This free service is provided by the Area Agency on Aging)
Use their online Email Request for Help form on AZSHIP.org
(For those who liked emailing me their drug list in the past, this is for you!)
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Call 1-800-432-4040 to leave a message and get a timely returned call.
(No Long Hold Times)
FAQ - Advantage Plans
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I have an Advantage Plan - What should I do?
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Advantage Plans have a lot more moving parts than Stand Alone Drug Plans do, and so require much more thought and caution when changing. Remember they cover your Medical and Hospital Providers in addition to your Prescription Drug coverage all in one package.
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Look for and read your ANOC or Annual Notice of Change letter mailed to you by your current plan sometime in September. The is the full description of your current plan and the upcoming changes in 2025 to your premium and or coverage.
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(If you threw it out by mistake, please call the member services number on the back of your card and request they resend it to you.)
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If you are happy with the changes and wish to keep the plan they are offering you then you can simply DO NOTHING and let it renew into the 2025 coverage and rates.
If I am your current Broker and you have questions or would like to shop new
plans for 2025, then please call me! I always enjoy hearing from you and catching up.
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NOTE - Due to the changes brought about due to the Inflation Reduction Act and other fiscal policies, many Advantage plans will see a reduction in the Extra Benefits or "Goodies" as I call them such as dental, vision, transportation, food cards etc. Many will also increase copays and out of pocket maximums for Parts A and B to compensate.
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Pro Tip - Whether you are being cancelled and need to pick a new plan, or simply want to shop the new plans - I strongly recommend you call any providers you really want to keep to verify they are taking the plan you wish to have in 2025. Keeping providers can be a real issue for many with Advantage HMO plans. Advantage PPO plans appear to generally be more stable, which is just one of the reasons why I prefer them.
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Being Cancelled may be a Blessing in Disguise
if your Advantage plan is being cancelled, this may be a blessing in disguise as it gives you a Guaranteed Issue period to switch back to Traditional Medical and buy a Supplement with NO Medical Questions asked!
If this is your situation then please call me to discuss. My personal belief is there is no better coverage in America than Traditional Medicare with a Supplement.
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If you value Simplicity, Predictability and Stability, a Supplement may be right for you!
Medicare Disclaimer​
“We do not offer every plan available in your area. Currently we represent 6 organizations which offer 41 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health insurance Program (SHIP) to get information on all of your options.”