I just received an email from MedicareChoices.org claiming that 35% of Medicare recipients with diabetes choose Medicare Advantage plans over Original Medicare or a Medicare Supplement. Ninety-five percent of them are happy with their plans and that their annual savings are $3400. That is immensely powerful information and tends to make the MAPD plans more user friendly and much less expensive than either Original Medicare or a Medicare Supplement.
The information is accurate but does not tell the entire story. Original Medicare covers diabetic supplies as does the Medicare Supplement. With each of the latter plans, the Medicare recipient can go to any doctor, any hospital anywhere in the country if that facility or doctor takes Medicare. You cannot do that on MAPD plans. You must stay in their network. Many seniors have become accustomed to that so to them there is no inconvenience. However, if you want choice, then either Original Medicare or Medicare and supplement might be better options. The article did not mention the other options.
Original Medicare covers the diabetic drugs Part B, not the drug plan. That makes the costs less overall because insulin is covered at a $35 copay because of the inflation reduction act signed by President Biden. The supplement treats insulin and diabetic supplies in the same manner as Original Medicare except any excess charges would be picked up by the supplement. Regardless, diabetic seniors are now paying less for diabetic supplies than they did before the inflation reduction act was passed.
Personally, I prefer the Medicare Supplement because it picks up the charges and excess that Original Medicare does not and the financial liability is significantly less under the supplement. It also allows you to see any doctor, go to any hospital as long as they take Medicare. Remember, Original Medicare does not have a maximum out of pocket thus leaving the senior with excessive bills for serious illnesses.
Clark County Nevada, which includes Las Vegas and Henderson, almost 80% of the senior population are on an MAPD plan. There are eighty-four different plans in Clark and Nye counties to choose from. They include HMO, PPO and Special Needs plans geared toward specific illnesses. Of course, all the plans advertise confusing the senior even more. The only way to pick the best plan
for you is to evaluate them using the metrics that include are my doctors covered and are my medications covered at what price? This is not an easy task, and I would recommend an independent broker who works for themselves and not the insurance company. In-house or brokers who work for a specific insurance company can only offer you, their plans. While an independent broker has all the plans and will assist you in finding the best fit for you. With all the options in Clark County using an independent broker makes sense. They have the tools to review your doctors and medications and guide you to the plan that fits your current needs. As an MAPD client you have two times annually where you can revisit your options and make changes if necessary. October 15 through December 7th and once more between January 1st and March 31st.
These MAPD plans also include added benefits such as gym memberships, post-hospital meal support, vision and hearing exams, glasses, and hearing aids. They may also provide direct reimbursement to help cover doctor visit costs, as well as chiropractic and podiatry services. Skilled nursing facilities, and many other benefits not covered by Original Medicare. Many of these MAPD plans also offer physical, speech, and language therapy. Each insurance carrier offers a little something different that makes them stand apart from their competition.
When evaluating the benefits of each of your options, please remember to make sure your medications are covered at a fair price and that all your doctors are on the plan you choose. Some seniors want to change their doctors so look at their doctor list to determine which doctor or doctors you want to see. There are so many options I would suggest you seek help from a broker who has been in the Vegas market over 10 years at least because they have the knowledge and tools to help make your choice easier. Remember, all MAPD plans pay the same commission, so the broker is impartial and not commission driven.
Know the times when you can change plans and look carefully at the plans before you decide in what direction you will go. Lastly, if you have special medical needs there are plans available for heart disease, chronic pulmonary disease, and other specific diseases.
I hope this clears up any concerns or issues relating to choosing the best Medicare option for you but like most things, there will be questions. Please feel free to either call me, email me or set up an appointment to meet and get answers to your questions. There is no obligation on your part to buy from me. Of course, I would like your business, but you are free to choose another broker or agent to help you.
My credentials are 23 years as a Medicare broker here in Las Vegas and not having one complaint or issue against me on that time. I carry Errors and Omission insurance in the event there is an issue but to-date, no issues or complaints, or claims. Member of NAIFA (National Association of Independent Financial Advisors) and NABIP (National Association of Benefits and Insurance Professionals).
Also, you may want to take a look at 2026 Medicare Information.
The Barend Agency Inc. Len Barend, broker 702-250-2200
