How we help
The yearly review
Between October 15 and December 7 we re-check the plan you have against every plan you could have. Most years the answer is stay where you are, and that is a real answer.
What changes every January
- The drug list, and which tier each of your prescriptions sits in
- Which pharmacies are preferred
- Which doctors and hospitals are in network
- Copays, the yearly out-of-pocket maximum, and the premium
- Which services need approval in advance
- The plan’s Star Rating
Your plan is required to tell you all of this in an Annual Notice of Change, which lands by the end of September. It is thick, it is dull, and the part that matters to you is on page nine.
How the review works
- Late September. Your Annual Notice of Change arrives. Put it aside unopened if you like; we will read it.
- Early October. We call you. We confirm your prescriptions and your doctors, because both change more often than people expect.
- Mid October. We run your list against every plan in your county for the coming year and price the whole twelve months.
- Before December 7. We tell you to stay or to move, with the numbers. If you move, we do the enrollment and it starts January 1.
Most years, for most people, the honest answer is stay put. We say so, and it costs us the commission a switch would have paid. That is the arrangement.
If you are on a supplement
Medigap coverage does not change in January, because it is standardized by law. What can change is the premium. Once a year we check whether the same letter is meaningfully cheaper elsewhere, and if it is, we will tell you what switching would involve, including the health questions.
Between reviews
The review is once a year. The rest of the help is not seasonal. If a claim comes back wrong, if the pharmacy charges you something strange, if a specialist tells you they no longer take your plan, call us the same week. We will call the plan and stay on hold.
That work earns us nothing. It is the reason people stay with us for a decade, which does.
Ask us to review your plan this fall.
You do not need to have bought anything from us. Send the first two pages of your Annual Notice of Change and your prescription list, and we will look.