Are you newly Medicare eligible (turning 65), planning to retire soon, or have you had Medicare for years and wonder if you’re in the right plan? Regardless, Medicare can be confusing.
Ryan Dolan, Medicare Field Sales Manager at Excellus BlueCross BlueShield offers the basics on Medicare.
Who is eligible for Medicare?
Anyone 65 years of age or older is eligible for Medicare. You also could qualify if you receive Social Security disability for 24 consecutive months or if you have certain chronic conditions.
We hear A-E-P referenced when talking about Medicare. What is A-E-P and why is it important?
AEP is the abbreviation for the Medicare Annual Election Period. AEP is typically the one time each year when you can make changes to your plan. It runs every year from October 15 through December 7. If you’re happy with your plan, then you don’t have to make a change. Or, if you’re only enrolled with original Medicare parts A (hospital) & B (medical), then this is your chance to get enhanced coverage with a Medicare Advantage plan.
Who needs to pay attention to AEP?
Anyone who is already on a Medicare plan should pay attention to AEP. It doesn’t mean you have to change anything. Available plans and options – as well as your health conditions and medications – can change every year. It’s always a good idea to see what is out there and look at your options.
I’ve heard that there are $0 plans out there. It seems too good to be true. Could a $0 plan be a good option for me?
We have many great plans out there with low or no premiums each month! A $0 plan means you don’t have to pay a premium each month, but it doesn’t mean you won’t have any out-of-pocket costs (such as co-pays when you go to the doctor). $0 plans are typically for those who don’t use a lot of medical services outside of routine care (such as preventive care with your PCP or seeing specialist from time-to-time). These plans provide your core medical benefits – as well as things that original Medicare doesn’t cover, like preventive dental and eye care.
I heard that Excellus BCBS received a 5-Star Quality Rating from CMS. What does this mean?
The Centers for Medicare & Medicaid Services (CMS) gives Star ratings to health plans every year based on quality performance in clinical care and outstanding service to their Medicare members. We are proud to say that our HMO plans have been awarded the highest possible star rating – 5 out of 5 Stars. And for the sixth year in a row, our Medicare Part D prescription drug plans also received a 5-star rating. Our PPO plans earned a 4.5 Star rating, the second-highest rating. Plans with a 5-star rating can offer a special enrollment period where you can switch your coverage to a 5-star plan outside of AEP (between December 8, 2021 and November 30, 2022).
What are some reasons I might want to think about changing my plan?
Available benefits and plans change each year, so it’s always a good idea to do your research. It’s also important to consider any changes in your health or life situation that might impact your needs. Have you been diagnosed with a chronic condition or has your income dropped sharply? Are you planning to have a surgery or procedure in the upcoming year? Do you need to see a specific doctor who doesn’t participate in your current plan? Are you covered through your former employer, but learned that they are changing its retiree health benefits? These are all reasons that you may want to consider switching plans.
This is great information, Ryan. But do you have someone who can help me compare plans and figure out what’s best for me?
Absolutely! Excellus BCBS is a local organization and our Medicare experts live and work in our community. We can walk you through all available options and help you choose a plan based on what’s right for you. There’s a variety of ways we can meet based on your comfort level: in-person appointments, phone appointments, in person seminars or online seminars.
For more information or to schedule an appointment, go to excellusformedicare.com or call 1-(800) 697 - 0700 (TTY: 711) 8 a.m. to 8 p.m. seven days a week, from October 1 until December 30, and 8 a.m. to 8 p.m. Monday-Friday from January 1 – September 30.
Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. All rights reserved. Excellus BlueCross BlueShield contracts with the Federal Government and is an HMO and PPO plan with a Medicare contract. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. Our Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
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Excellus BlueCross BlueShield, an independent licensee of the Blue Cross Blue Shield Association, is a nonprofit health plan with 1.5 million upstate New York members. The company's mission is to help people live healthier and more secure lives through access to high-quality, affordable health care. Its products and services include cost-saving prescription drug discounts, wellness tracking tools and access to telemedicine. With more than 3,500 employees, the company is committed to attracting and retaining a diverse workforce to foster innovation and better serve its members. It also encourages employees to engage in their communities by providing paid volunteer time off as one of many benefits. To learn more, visit ExcellusBCBS.com.