Plain Talk on Medicare
Straight answers from a licensed independent agent, no jargon.
Welcome to your August edition. As summer winds down, so does the quiet season on your Medicare plan — the next 60 days set the stage for everything that happens at renewal. Consider this issue your pre-season checklist, built to keep you informed and protected before the paperwork lands in your mailbox.
Medicare News & Education
What Your Annual Notice of Change Is Really Telling You
Every plan is required to mail an Annual Notice of Change, or ANOC, by September 30. It is easy to set this envelope aside with the rest of the mail. That would be a mistake.
The ANOC outlines what is changing in your coverage starting January 1: premiums, deductibles, copays, and the list of covered drugs. Most people skim the summary and miss the details that matter most.
Three sections deserve a close read this year.
Premium and deductible changes. Even a small shift compounds over twelve months. Compare the new numbers to what you paid this year, not to what you expect to pay.
Provider network updates. A plan can keep its name and still change which doctors and hospitals are in network. Confirm your specialists are still listed before you assume nothing changed.
Drug formulary tier movement. This is where most surprises hide.
Why Formulary Tier Shifts Quietly Raise Your Costs
A formulary is the list of drugs your plan covers, organized into cost tiers. Insurers are permitted to move a drug to a higher tier, or off the list entirely, from one year to the next, even if you have taken it for years without issue.
A medication that cost you a small copay this year can jump to a coinsurance percentage next year with no warning beyond the ANOC. That difference can mean paying hundreds more annually for the exact same prescription at the exact same pharmacy.
The only way to catch this early is to cross-reference your current medication list against next year's formulary, tier by tier, before the change takes effect. Waiting until your pharmacy runs the claim in January is the most expensive time to find out.
This Month
August is National Wellness and National Immunization Awareness Month
National Wellness Month and National Immunization Awareness Month both fall in August. It is a fitting time to schedule your annual wellness visit if you have not already, and to confirm with your physician that your recommended vaccinations are current. Both are covered preventive services under most plans, and both give you one more data point to review before your ANOC arrives.
A Little Levity
Why did the skeleton miss the deadline for Medicare open enrollment?
He didn't have the guts to decipher the paperwork, and he lacked the vision to see if his coverage changed!
Your No-Cost 3-Step Medicare Risk Audit
Reading an ANOC on your own is a reasonable start. Reading it correctly, and knowing what it means for your specific doctors and prescriptions, is a different task entirely. That is the work we do for you, at no cost, as your No-Cost Medicare Concierge.
Our No-Cost 3-Step Medicare Risk Audit gives you a clear, written picture before you decide anything:
Network Cross-Reference — confirming your doctors and specialists remain in network under any plan we review.
Formulary Tier Analysis — checking every medication you take against next year's coverage list, tier by tier.
Out-of-Pocket Cap Modeling — projecting your realistic annual costs under your current plan versus the alternatives available to you.
There is no obligation and no sales pressure attached to this review. It exists to give you facts before your plan's changes take effect. Reply to this email, call us at (561) 444-8975, or book a time online to schedule your audit before the Annual Election Period begins on October 15.
Howard Sobel and Legacy Health Advisory Group is an Independent Medicare advisor helping people choose the right plan with confidence, not confusion.
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Disclosures: Legacy Health Advisory Group is an independent, licensed entity operating under Sobel Ventures Group, LLC. Legacy Health Advisory Group is a licensed insurance agency and is not connected with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.