347 N. Pottstown Pike, Suite 200 | Exton, PA 19341

Shopping my Plan During AEP

Get AEP Ready – Everything you need to know about AEP Shopping – 41 mins

Differences between Medicare Supplement and Medicare Advantage – 15 mins

Reviewing your Coverage

We recommend that if you have a Standalone Prescription Drug Plan (Part D / PDP) or a Medicare Advantage Plan, that you review your coverage each year during the Annual Enrollment period 10/15 to 12/7.

HTA provides 2 options that make this easy–exclusively for our Medicare Clients!!

  • OPTION 1: Schedule a 45 minute phone consultation
  • OPTION 2: Submit an online request form to request we review and email you the analysis
    • Available for standalone PDP only (schedule for Medicare Advantage)
    • Please complete separate form for each spouse/partner.

If you are content with your current plan, after we confirm there are no major changes, you can DO NOTHING and your plan will automatically renew with the new premium and benefits.

If you are not happy with your current plan, we will help you select and enroll in a new plan.

How to be prepared for your phone consultation

We have a number of clients that need our assistance this year, so to make the best use of the time we have together on the phone, please make every attempt to be prepared for your phone call.

  • Be ready at your appointment time and answer your phone when we call
  • Be in front of your computer with access to your email
  • Have your prescription bottles in front of you
  • If you want to shop your Medicare Supplement, know your premium and any rate increase info you may have recently received.
  • If you want to change from Medicare Supplement to Medicare Advantage, watch the first 15 minute video above on the Differences between Medicare Supplement and Medicare Advantage.
  • If you want to shop a Medicare Advantage plan, have a list of your doctors prepared.

Medicare Part D Prescription Drug Coverage

This can be purchased as a standalone plan or included in your Medicare Advantage Plan.

Medicare Part D is designed to coverage prescriptions drugs which are filled at a pharmacy and taken by the patient in a home setting. This coverage is often simply referred to as Medicare Prescription Drug Plans or PDP.

The plans are not designed to cover over the counter medications, vitamins, or medications which are used for cosmetic purposes or those for which there is a comparable over the counter version available such as cough medications or some allergy medication. While Medicare Part D is offered by private insurance carriers, Medicare does set rules regarding their coverage and they must be authorized by Medicare.

Every Medicare Part D Prescription Drug Plan (PDP) will have 4 stages of coverage dependent upon how high your medication costs may become during the year.  Regardless whether you purchase a standalone PDP or you have a PDP coverage through your Medicare Advantage Plan, you will have 4 stages of coverage.

However, Part D coverages may have different formulary lists (which medications they cover), tier rankings (cost sharing assigned during the Initial Coverage Stage), and network pharmacies.  Some plans may have quantity limits (QL), prior authorization (PA) or step therapy (ST) restrictions on medications.

For more detailed information on Medicare Part D Prescription Drug Plans and how the stages of coverage work, please visit our Part D Informational Page.

Medicare Supplement Plan

Medicare Supplement Plans do not apply to the Annual Enrollment Period.  The contract does not change annually.  You may have a premium change on your plan annually, but many times this will occur on the annual anniversary date of when you purchased your policy.  

We are available to help you shop this plan as well.

If you want to stay with Medicare Supplement– we can shop anytime through out the year, and you can change for the first of the following month.  It often makes sense to schedule an appointment for January (or leading up to your annual anniversary date) to do this since insurance companies are very busy during AEP and there could be extended delays in processing.  This will also allow us the full 45 minute AEP phone consultation to get your prescription plan in order (since this is on deadline for 12/7) and address the Medicare Supplement afterward when there is more time to focus on the options.  However, if you would like to shop during AEP, we are happy to do so.  Please be prepared for your appointment with your current premium and any rate increase information you received from your insurance company.

If you are thinking about moving to a Medicare Advantage- we will need to discuss this during AEP since you can only enroll in Medicare Advantage Plans between 10/15 and 12/7 for a 1/1 start date.

Understanding the differences between Medicare Supplement and Medicare Advantage…

Both Medicare Supplement and Medicare Advantage can be attractive coverage options when you are enrolled in Medicare.  Please watch our video on “Differences between Medicare Supplement and Medicare Advantage” at the top of the page.

What is most attractive to you will depend on your individual preferences.

When can you change?

Please call for an appointment.

From Medicare Supplement to Medicare Advantage – No Medical Questions required.
  • During the Annual Enrollment Period from 10/15 to 12/7.
    • Your policy will be effective 1/1.
  • You will need to contact your Medicare Supplement Company to cancel once you are approved.
  • You do not need to cancel your current Part D Plan because it is automatically cancelled by your Medicare Advantage enrollment.
From Medicare Advantage to Medicare Supplement – Medical questions will apply.
  • During the Annual Enrollment Period from 10/15 to 12/7.
    • Your policy will be effective 1/1.
  • OR: During the Medicare Advantage Open Enrollment Period from 1/1 to 3/31 –
    • Policy can be effective the first of the month of your choosing (after approval) between 2/1 and 4/1.

Do not cancel your Medicare Advantage Plan until you have a formal approval from the Medicare Supplement insurance company

  • If you do not receive an approval by 12/7, you will need to renew your Medicare Advantage Plan for 1/1 and wait for the approval. You will then need to change your Medicare Supplement effective date to either 2/1, 3/1, or 4/1.

If you are enrolling in a Medicare Supplement Plan, you will also need Medicare Part D prescription drug coverage.

  • Once approved, you can cancel your Medicare Advantage by enrolling in a standalone PDP.
  • Please remember do not do this unless you know you are formally approved for your Medicare Supplement (or you will be transitioned back to Original Medicare Only and can only add a Medicare Advantage Plan again during the Annual Enrollment Period from 10/15 to 12/7 each year.

For more detailed information on Medicare Part D Prescription Drug Plans and how the stages of coverage work, please visit our Medicare Supplement  AND/OR   Medicare Advantage Informational Page.