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MEDICARE SECTION:t
The Annual Enrollment Period is almost here!
Since Excellus BCBS (NY) mailed notices this week (the "cat is out of the bag") let's talk about those changes.
I am writing about this Excellus BCBS (NY) PPO plans because I see this as the biggest disruption for 2027. This will impact over 530 of my Excellus BCBS clients alone!
Traditionally, Excellus BCBS (NY) has been a PPO Medicare Advantage (Part C) plan company. (PPO plans offer in-network coverage and out-of-network coverage and benefits).
Now all their PPO plans in NY state are being terminated effective December 31, 2026. This means that if you don't make a plan change for 2027 your Excellus PPO will terminate and you will go back to original Medicare Part A and Part B with no prescription (Part D) coverage.
Keep in mind, with no Part D drug plan longer than 60 days, once you finally enroll in a Part D plan later you will now be faced with life-time late enrollment penalties.
Excellus BCBS (NY) will now offer only HMO Medicare Advantage plans. (HMO plans offer only in-network coverage. You will be working closely with your primary care doctor. If you need a referral out to a Specialist, your primary care doctor will refer you. HMO plans are harder to travel with (across the United States). If you go out-of-network there is no out-of-network coverage). Some HMOs will be offering an out-of-pocket limit (like maybe $3,000) to spend if you need to go out-of-network (like for "snow birds").
You will be seeing other carriers terminating Medicare Advantage plans. Others will be pulling plan out of certain counties while offering new options in their place. Some plans will automatically switch to another plan name (called "cross walked").
Also, another big disruption: agent and brokers won't be able to enroll or switch their clients into Part D prescription drug plans; and the plans are not paying commissions. I can still help clients determine which stand-alone Part D plan would work best for them in 2027.
Most Medicare Advantage (Part C) plans have the Part D prescription coverage built in. This is different from the stand-alone Part D prescription plans. I can still offer Medicare Advantage plans with Part D included. These are the plans that also offer ancillary coverage included like: dental, vision, hearing, hearing aids, gym memberships.
The Part D prescription deductible on most plans will be raised to $700, the CMS ceiling, while some annual prescription deductibles will be lower on other plans. This year (2026) the annual Rx deductible ceiling was $615.
We are still waiting on what the Part B premium will be assessed at for 2027, which is based on the C.O.L.A. This premium is what you pay for Part B (doctor/medical) coverage, which for most is deducted out of your Social Security check.
For now, it would be VERY helpful if you need an appointment with me AND have more than 5 medications to pull up www.Medicare.gov
to create a sign in and password. Please make sure you keep this sign-on and password. I will ask you for it during our appointment to access the account. Then you will enter and list your medications here along with the milligram dosage. The program will then ask if you pick up your medications every 30 days or 90 days, as prescribed. You will enter that also. Once you build your list, save. This will be the biggest time saver for both of us.
For the appointments, I will be asking you for a list of your medications (for my records) and a list of your doctors. You will also need to have handy your Medicare (red, white, and blue) Medicare card in order to make any change to your insurance plan.
Please make sure everyone is using my email address: tcangemi@RetirementHPMS.com
For now, I am scheduling appointments as they are requested and finding time slots for everyone. The appointments are being scheduled every two hours. I need to try to keep the appointments within 2 hours. Some appointments may run over. Please be patient.
Please do NOT email your lists of doctors and medications until you have an appointment scheduled with me. This will be a time saver determining how to match up paperwork. Please make sure your name is on top or included in your lists. TY
Three ways to contact me for appointments:
voicemail (if to long to listen to), email, or text message.
If using text message, please make sure your name is somewhere in the texting message.
I think that is everything for now. It's going to get busy!!
NOTE: It may take longer to hear from me September 30th to October 8th. I have a prior commitment. Nope, I am not on vacation .. lol.
I appreciate your business. Have a wonderful day!
Theresa Cangemi
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