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It’s that time of the year where existing Medicare members can make important changes to their healthcare plan. This is the time of year where insurance agents are flooded with calls from Medicare recipients. Because it takes time to carefully review all your options and then implement needed changes it is recommended that you start planning in early October to get a timely December 7th (deadline) submission. If you have Medicare here are some key reasons why a review of your plan may be in order.


According to the American Association for Medicare you can save up to $500 per year when reviewing and changing prescription drug plans alone. Household discounts can offer up to $700 savings per year. With many people choosing Medicare Replacement/Advantage Plans (also known as Medicare Part C) this is a time where you want to look at those premiums and deductibles. How much did they increase? Were you really saving money over the course of the year compared to original Medicare? Everyone’s situation is different, so what may be a huge savings for one person may actual be a large increase in cost for another. To get a better idea of some of the costs, you can go to


Providers frequently become unavailable for a variety of reasons. They merge, go out of business, retire, etc. This results in limited coverage for those Medicare Replacement/Advantage Plans. If you are a fairly healthy person, this may not be an issue for you and the monthly savings make it a more economical decision. If you require the services of specialists, this may be an issue. Your Replacement plan may make an exception due to this, however it often comes with a restricted number of visits.  Also you may not have realized until further along in your plan that it does not cover a particular drug that you now need.

Claim Denials

This is yet another form of hidden costs. Medicare has a long list of codes for covering anything you medically need. Some codes Medicare will pay for, and some they will not. Replacement plans often have a higher number of denials for various reasons. This may not have been an issue when you first got the plan, but let’s say you suffered a stroke and now you are realizing the various things you need but your plan is not covering. Denials can be a significant set-back to the budget and often lead to patients changing their plan of care as soon as possible.

Why Use an Insurance Professional?

Medicare insurance plans are difficult to understand with all of their complexities. They even vary in their rules and savings from state to state. Much like hiring a good CPA for your taxes, the savings can range greatly when using a qualified insurance agent to help choose the best Medicare plan for you. When doing this, it is to your benefit to use a local agent within your state as they tend to be more familiar with such regulations and potential savings. You can find a local agent by going to .  For Lake County, Florida we have been working with Emily Johnston at Pinnacle Retirement Advisors and have been more than happy with her attention to details and customer service. Changes in your plan for this open enrollment period take effect on January 1, 2023. Get your new year started off right with a plan that works best for you!