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
last year changed 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.
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 with by insurance carrier:
- UHC changed the names of all the plans in Nevada, but the benefits themselves are mostly the same.
- More plans with Point-of-Service (POS) dental options. Standard coverage for preventative and basic care raised from $2,000 per year to $3,000
UHC’s #1 plan in the area was named “AARP Medicare Advantage Walgreens Plan 1”. It has been renamed “AARP Medicare Advantage Walgreens from UHC”. This premier plan still features:
- UHC’s Passport program is going strong. This program allows much more flexibility getting care when traveling across the United States
- UHC UCard can still be used to purchase a variety of items in services. It began as a pharmacy over-the-counter cash card and has expanded over the last two years:
Earn UCard funds for certain health-related tasks such as
- Using Telehealth appointment
- Getting an annual flu shot or mammogram
The funds can be used in many ways:
- Over-the-counter pharmacy benefits
- Funds for dental, vision, and hearing out-of-pocket costs
- Healthy foods and related
Continuing Wellness programs
Register for online access: https://www.medicare.uhc.com/
New options added to Humana’s already fine lineup:
Two “Humana Gold Plus” HMO Plans
- One with $100 Part B giveback. That means Humana pays $100 of your Medicare Part B premium
One HumanaChoice PPO emerges as their main Vegas PPO
- Dental coverage upped to $3,000 annually
Expanded options for Humana Flex Card (debit card)
For enrollees on Medicare and Nevada Medicaid
- “Healthy Options Allowance” can be used for rent, utilities, groceries, as well as pharmacy over-the-counter
Wellness programs- new and continuing
Register for online access: https://www.humana.com/member
- No new plans announced for 2024
OTC flex debit card
- $100 per quarter
- Various uses
Wellness Programs – continuing.
Register for online access: https://www.aetna.com/AccountManagerV3/register/selfService/registerMember
- No significant changes
Register for online access: https://www.anthem.com/register/
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
- No significant changes
Register for online access: https://member.wellcare.com/Registration/Member
Other 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. When 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/