Welcome to insurance talk with Cheri Martinen. I am here today with a special guest from PacificSource, Emily Kerrick. She takes care of us for everything Medicare at PacificSource. We are excited to have her here today, because 2022 is looking very good for PacificSource and Medicare Advantage Plans.
Review the 2022 PacificSource Medicare Advantage Plan Details
Jump right to the facts and compare the PacificSource Medicare Advantage Plans Options.
Let’s start with one of the biggest changes to PacificSource Medicare Advantage Plans for 2022, which is lower rates. PacificSource has been able to receive some additional funding for 2022 for Medicare and as they are a not-for-profit organization they like to give that money back to their members whenever possible. And, that’s exactly wat we’re able to do next year. So you won’t be losing any benefits if you see your rate go down, the lower rate is due to the additional funding being passed onto members. Along with the lower rates, members can expect to see lower copays when they see the doctor as well as lower prescription drug deductibles on different plans.
For our members the RX27 Plan is a fan favorite plan. It is the least expensive plan that is available right now, which includes Part D prescription drug benefits and is currently $55 a month. However, starting January 1st this plan will automatically drop to $40 a month due to the additional funding we mentioned. So $15 a month savings right off the bat. Also, currently on this plan members pay $35 for each copay, but starting January 1st this will automatically drop to a $19 copay for doctor. For specialist appointments such as dermatologists, cardiologists, and ophthalmologists members will see those drop from $50 each visit to $39.
PacificSource offers great extra benefits. One of the new big things for Central Oregon starting in January is that all of our plans will include some form of dental embedded into the plan. Which means it’s available to Medicare Advantage Plan members at no additional cost. People have been waiting for this benefit for a long time, this is HUGE!
So on the RX27 Plan, starting in January the plan will include some preventative dental benefits as well. For example if you go in once a year for your dental cleaning and exam, you ordinarily get a bite wing but now you will be covered for x-rays as well for in network providers. If you are unsure if they are in network, you can simply ask them to verify or call PacificSource directly to ask.
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There are also a lot of members on plan RX14 plan, which is currently $99 a month and will be going down to $96 a month in January. The same preventative dental benefits will also be added to that plan at no additional cost to the member. Additionally with the RX14 plan, currently members who take brand name medications are having to pay the first hundred dollars out-of-pocket. That is called the annual prescription drug deductible. But, starting in January, that one hundred dollar deductible is going to zero. So for the first time they fill any covered medication in January, they don’t have to pay out-of-pocket up to the first hundred.
Zeros are good to see and speaking zeros, we also have a zero premium plan. The reason we are able to offer a plan for zero, in case anyone’s wondering, is due to the funding that PacificSource gets from Medicare each month to help subsidize the cost of care for the members. Similar to other health plans.
For Veterans, we have a plan called Essentials 2 Plan, that is also a zero premium plan. This is great for people that have Medicare and VA benefits. It just gives them options if they wanted to seek care outside of the VA system, or if it’s more convenient or timely. In 2022 they’ll have no copay, no out-of-pocket costs for any doctor visits with doctors in our network. So zero copay if they see a primary care doctor in our network or zero copay if they see a specialist in our network. All Zeros!!
As a reminder, PacificSource’s network is not just Central Oregon area. We have contracted doctors that our members can see in all different parts of Oregon, including OHSU in Portland where a lot of people go for specialized care.
In January 2021 there was a new benefit announced that will be continued and expanded on in 2022. That is the Rewards for Healthy Actions, which basically means you can earn a gift card for going in for a preventative care screening. There are hundreds of different stores you can choose from for your gift cards as well. So there is truly something for everyone, whether it’s a gas card, Amazon, Safeway, Home Depot, etc. Currently our members who go in for an annual physical or a Medicare annual wellness visit can earn a $50 gift card. Members who go in for a mammogram can earn a $25 gift card. For diabetes there are a couple different options. For those that get their first A1C tests can earn a $15 gift card and for the second you can earn a $25 gift card. Further, there are a lot of diabetics that aren’t aware that they also qualify for a free annual eye exam under Medicare, and not only is it free but they earn a $25 gift card for doing it. Next year, we’ll be adding to it with a flu shot or a fit bit.
Another new benefit for 2022 is for hearing needs. We will be utilizing a company called TruHearing and we’re adding an even lower cost hearing aid option for our members through this program. Starting January 2022, this plan will only be $599, down from $699 in the 2021 Plan year. To put that in perspective if you have never shopped for hearing aids, they’re typically several thousands of dollars. I recently was at a meeting when we were rolling out this program and telling members about it. A man came up to me and said he just spent $7,000 on a pair of hearing aids, where on the TruHearing Program he could have gotten them for under $2,000. Additionally, you get a year’s worth of batteries or a discount on a rechargeable battery option. And, if you lose them or a dog chews them up, they will replace it for free the first time for you. So, if you have been putting off getting your hearing checked you don’t have to on this plan its $0 to get it checked out.
PacificSource plans also include Silver and Fit benefits, which allow members the ability to join fitness facilities, in-home workouts and an annual Home Fitness benefit with a wearable fitness tracker at no additional charge to the member. So, if you are on a PacificSource Medicare Advantage Plan you can call them up and order a free Fitbit or Garmin watch to track your overall health and fitness.
There are a few other benefits that are very nice and included on PacificSource Plans, which most are not included in Original Medicare.
We’ve spoke about the hearing and dental benefits, but you also have access to Chiropractic Services, Naturopathic Doctors and Acupuncture. As long as they are part of the PacificSource network your visit will only cost a $25 copay per visit for up to 12 visits per year. This can be any combination of these types of chiropractic, acupuncture or naturopathic doctor visits.
Plans also include vision benefits that reimburse you for glasses or contacts up to $200 every two years. This benefit allows you to purchase lens, frames or contacts wherever you would like and then you just submit the receipt to us with your information on it and we’ll get you a reimbursement check in the mail, up to your $200 benefit.
Another benefit available at no charge to you that has become very popular in the past two years is telehealth. If your providers office offers telehealth visits via FaceTime or Zoom, that visit will be covered just the same as if you were in their office. This is a great option for routine visits where you don’t have to worry about travel or exposure to others.
Speaking of travel…our goal is to make sure you’re not worried when you travel about what might happen. If you were traveling and happen to get sick or in an accident and need immediate medical attention via urgent care or the emergency room you will be covered worldwide.
Listen to the full podcase above to hear about all of these great improvements to the 2022 Medicare Advantage Plans available from PacificSource.
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Disclaimer: This content is provided for general information purposes and is not intended to be used in place of consultation with our agents.