A Review of Medicare Drug Coverage —
With or Without a Consultation

During Open Enrollment, most people have 20 to 50+ different options for Part D or Medicare Advantage with drug coverage available to them. Which one is best? Know for certain with an expert review of your drug coverage.

We hear this all the time... "My plan was just fine this year. Why would I make a change?"

Each year, insurance companies can make drastic changes to Part D drug plans and Medicare Advantage plans.

• Premiums and deductibles can be added or increased
• Copays for medications can go up
• Preferred pharmacies might no longer be in network
• A vital medication might be dropped from the formulary — meaning the senior must pay the full cost of the drug
• Prior authorization may now be required before the beneficiary can get certain medications

All of this and more can change while the plan keeps the same name.

To ensure that clients remain in the best plans for their unique needs, i65 provides the client with an unbiased, expert review of their drug coverage — with or without a consultation.

SERVICE GOALS

Through this expert service, clients will learn:

• How the current drug coverage will change in the coming year — Higher premiums, drug deductibles, or out-of-pocket costs? Will any pharmacies no longer be in the network? Will prior authorization or step therapy be required for certain medications?
• What Medicare plan would provide the best drug coverage for the client's unique needs — Your Medicare expert will narrow down the plans to the best two option, in addition to the client's current plan. These plans are presented in a detailed, side-by-side comparison with a specific plan recommendation. The client is then able to choose the plan(s) they prefer using the information provided.
• How the recommended drug coverage would work — Drug formularies, pharmacy networks, coverage restrictions, out-of-pocket costs, and more
• Optional — 15-minute consultation — With a consultation, the client can learn more directly from the Medicare expert about the plan recommendations and ask questions.

What's Included

• OPTIONAL — A 15-minute plan recommendation review consultation, provided via phone or webinar with a Medicare expert
• One personalized Medicare Plan Comparison report, provided in a PDF format, detailing key cost, quality, and coverage factors of the client's current plan plus two of the most cost-effective plans in the client's ZIP code. The report also includes step-by-step instructions to enroll in specific plans.
• Answers to follow-up questions related to the plan review

The process:

1. To get started as an i65 user, log into your [i65 account][1] and order a "Personalized Medicare Consultation" service through the SERVICES tab on the navigation bar.
   To get started as a consumer, please call 65 Incorporated at 262-223-3433 to learn more about consultations and order the service.
2. A representative from 65 Incorporated will contact the professional advisor first. Then, the representative will reach out to the client to complete an online questionnaire which allows our team to better understand the client's unique needs.
3. Once the questionnaire is completed, if you've requested a consultation in addition to a report, 65 Incorporated will contact the advisor and/or client to schedule a time for the consultation and send out an email detailing the call in or webinar log in instructions.
4. Please set aside 15 minutes for the consultation.
5. The professional advisor, or, if no advisor is involved, the clients themselves, will receive a link to download the plan selection report (provided in a PDF format) within 5 business days.

IMPORTANT:

65 Incorporated only compares the Part D drug coverage of Medicare Advantage plans. We do NOT compare provider networks, health services, or extra benefits.

The process of comparing Medicare Advantage plans has become incredibly complicated in the last few years. In fact, it can take many hours to gather all the information on a plan, including networks, prior authorization restrictions, details on extra benefits, etc. Often, even after all of these hours, it is still not clear which plan to recommend — at least, not without a functional crystal ball. Unfortunately, while we can do many things to help our clients with Medicare, we cannot predict the future.

For more information on how to compare the health components of a Medicare Advantage plan yourself, please refer to "A Guide to Choosing a Medicare Advantage Plan: Using the Plan Finder" available through the resource section of the i65 software. With this guide, you'll be able to do the following:

• Check provider networks
• Identify any requirements for prior authorization or referrals
• Determine the price of various services
• Decipher the restriction or limits on the extra benefits (dental, vision, hearing, fitness, transportation, etc.)

65 Incorporated does not review Medicare Supplement (Medigap) policies for Open Enrollment.

Contrary to popular belief, Open Enrollment is for reviewing Medicare Advantage and Part D drug plans – NOT Medicare supplements.

Why? Unlike Medicare Advantage plans and Part D drug plans, you must have a [Guaranteed Issue Right][1] in order to be able to get a supplement without answering medical questions. Depending on your health, you may NOT be able to get a supplement plan. This is why we often advise people to consider their supplement as once-in-a-lifetime purchase, and it's also why we do not include Medicare Supplements as a standard Open Enrollment review service.

However, you can have your Medicare Supplement reviewed through the [Existing Coverage Review service][2].

ABOUT 65 INCORPORATED CONSULTING SERVICES:

One-on-One Consultations

Clients speak directly with experts from 65 Incorporated via telephone, webinar, or (if near SE Wisconsin) in-person.  

Trusted Medicare Experts

The team of consultants at 65 Incorporated are trained and overseen by nationally-recognized Medicare expert, Diane J. Omdahl, RN, MS.

Personalized Report

Everything you need to know about Medicare, including step-by-step sign-up instructions, are contained within your "Medicare RoadMap."

Unbiased Guidance

65 Incorporated does NOT sell insurance. We work on a fee-for-service basis, meaning our guidance is always in your best interest.

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