PivotPoint Advisors Annual Update: Medicare in and around Las Vegas
You may want to bookmark this page for your use throughout the year and to share with others who may also sometimes struggle with Medicare rules and products.
Medicare Annual Enrollment Period (AEP) runs from October 15th to December 7th. This is when all Medicare enrollees can make changes to their plan(s).
We brokers get an advance look at the annual changes each insurance carrier has made in their plans and policies. This document attempts to give you all the meaningful changes each year. We’ll stick to the bigger changes that move the needle for your Medicare coverage.
The passing of the Inflation Reduction Act changes the game. Medicare costs for some drugs is much more than health plans before age 65. The Medicare portions of this law (it does many other things) attempts to start fixing that. In brief, bullet-point form here are the big points. Starting in 2025:
- Medicare will have a $2,000 out-of-pocket maximum for prescription drugs (your Part D)
- 10 very expensive drugs (contact me for details) will initially be covered in 2026, moving to 20 by 2029
- Insulin capped at $35 per month
- CMS (Centers for Medicare and Medicaid Services) can now negotiate drug prices with drug manufacturers. The Pharmaceutical lobby had prevented this till now. This will lower the prices that members pay. In some cases, the difference will be huge.
In addition to changes brought about by the new law, the bigger companies are introducing flexible debit cards to extend the over-the-counter cash benefit. In some plans you can spend the benefit on dental or vision costs or even healthy food.
All private Medicare-related medical and hospital insurance falls into two buckets: 1) Medicare Advantage (aka Part C) and 2) Medicare Supplements (aka Medigap). Medicare Supplements change very little year to year. Premiums rise because of inflation but the policies stay the same. This document therefore will focus on the Medicare Advantage and Prescription Drug changes each year. But know that we love Medicare Supplements and offer complete service on those plans as well; just reach out.
I’ll cover the most significant changes by insurance carrier. If you do not yet have online access to your Medicare Advantage or Prescription Drug Plan account, I strongly recommend registering now….while you’re thinking about it.
- AARP Walgreens 1 plan now participates in UHC’s Passport program. This means members can get regular medical care while traveling throughout the United States with no penalty.
New UHC UCard product is available for most Medicare Advantage plans. This is a debit card that offers members $100 per calendar quarter (possibly more) for multiple purposes, including
- Over-the-counter pharmacy benefits
- Funds for dental, vision, and hearing out-of-pocket costs
- Healthy foods and related
Earn UCard funds for certain health-related tasks such as
- Using Telehealth appointment
- Getting an annual flu shot or mammogram
Wellness programs – new and continuing
Register for online access: https://www.medicare.uhc.com/
Shop and enroll for 2023 United Healthcare Medicare: https://integrity6.destinationrx.com/PC/2023/u/MTg2MjM5NTE?SourceSiteType=YnJva2Vy&AgentLoginDomain=SW50ZWdyaXR5X1BDQnJva2VyMjAyMF9QUk9E
- New HMO plan with Part B giveback. These plans offer higher medical deductibles in exchange for savings on monthly Part B premiums. In general, I don’t believe in them.
- New Flex Card (debit card).
Wellness programs- new and continuing
Register for online access: https://www.humana.com/member
Shop and enroll for 2023 Humana Medicare: https://integrity6.destinationrx.com/PC/2023/u/MTg2MjM5NTE?SourceSiteType=YnJva2Vy&AgentLoginDomain=SW50ZWdyaXR5X1BDQnJva2VyMjAyMF9QUk9E.
New HMO: “Aetna Prime Plus”
- $1,800 Comprehensive dental annually
OTC flex debit card
- $100 per quarter
- Various uses
Wellness Programs – new and continuing
Register for online access: https://www.aetna.com/AccountManagerV3/register/selfService/registerMember
Shop and enroll for 2023 Aetna Medicare: https://integrity6.destinationrx.com/PC/2023/u/MTg2MjM5NTE?SourceSiteType=YnJva2Vy&AgentLoginDomain=SW50ZWdyaXR5X1BDQnJva2VyMjAyMF9QUk9E.
- No significant changes
Register for online access: https://www.anthem.com/register/
Shop and enroll for 2023 Anthem Medicare: https://integrity6.destinationrx.com/PC/2023/u/MTg2MjM5NTE?SourceSiteType=YnJva2Vy&AgentLoginDomain=SW50ZWdyaXR5X1BDQnJva2VyMjAyMF9QUk9E
SelectHealth Medicare Essential HMO is the only 5-star plan in Nevada for 2023.
- 5-star plans have a special advantage: you can enroll in them any time of the year (once per year), not just during the fall season. This advantage is one reason plans strive for the 5-star rating
- Two new plans introduced in 2023: a PPO and an HMO designed for Medicaid/Medicare people
- Great plan for Intermountain Healthcare (IHC) doctors
Register for online access: https://myhealthplus.intermountainhealthcare.org/register/insurance
Shop and enroll for 2023 SelectHealth Medicare: https://integrity6.destinationrx.com/PC/2023/u/MTg2MjM5NTE?SourceSiteType=YnJva2Vy&AgentLoginDomain=SW50ZWdyaXR5X1BDQnJva2VyMjAyMF9QUk9E
Lasso is a Medicare Advantage plan. It is not HMO or PPO. It’s a Medical Savings Account (MSA). It’s a bit different; a possible substitute for a Medicare Supplement for many people
- Advantages: 1) $0 premium (by law) 2) Use any Medicare doctor in the country at any time 3) Deposits are yours to keep. Most commonly, MSA enrollees invest the remaining funds each year for long-term growth
- Disadvantages: 1) Some red tape. Members need to file an IRS form. 2) a little less familiar to most people—but very similar in design to Health Savings Accounts (HSAs)
Online info: https://lassohealthcare.com/
Shop and enroll for 2023 Lasso Medicare: https://bit.ly/PIvotPointMedicare-MSA .
- No significant changes
Register for online access: https://member.wellcare.com/Registration/Member
Shop and enroll for 2023 WellCare Medicare: https://wellcare.isf.io/2023?AgentCreditCode=75bd2edc-73f3-46da-8d9e-0c956d8852d2
Medicare Advantage Plans in Nevada Not Currently Offered by PivotPoint Advisors
Here is a list of the remaining, less popular Medicare Advantage plans in-state. PivotPoint does not currently offer these products, mainly because we see no client advantages in these plans. If warranted, we will contract with these companies—or others– in the future to maintain best-in-Vegas service.
Alignment Health: https://www.alignmenthealthcare.com/Locations/Nevada
Imperial Health: https://imperialhealthplan.com/nevada/clark/
Molina Healthcare: https://www.molinahealthcare.com/members/nv/en-us/hp/medicare/medicare.aspx
Senior Care Plus: https://www.seniorcareplus.com/plans/south/