The annual registration for Medicare, the federal health insurance program, has begun. This program affects the healthcare benefits of tens of millions of people aged 65 and older. Policy changes are possible every year, so taking advantage of the registration period to choose a suitable Medicare plan could save a significant amount of money and provide easier access to medical care.
In a recent interview, Zhang Tianning, the founder of Los Angeles Tianning Insurance and a senior broker for California health insurance, highlighted the complexity of the U.S. healthcare insurance policies. Regulations change almost every year, causing challenges for policyholders and even insurance brokers. The U.S. government mandates that insurance brokers must undergo annual training and exams to be qualified to conduct business.
Zhang Tianning explained that the external environment for health insurance companies changes yearly. The government’s requirements for insurance companies, the amount of subsidies they receive, and the external benefits provided to customers can vary annually. Some insurance companies may introduce new benefits for customers, which can result in cost savings for individuals.
The costs of Medicare continue to rise, now being the largest annual budget expenditure in the U.S., even exceeding the defense budget. Zhang Tianning cautioned that as insurance company costs do not decrease, the subsidies for premiums will only increase. While the federal government currently can provide subsidies for Medicare, the escalating costs may reach unsustainable levels in the future.
To prevent an affordability crisis, Zhang Tianning believes the U.S. needs to gradually reduce drug costs and prices. Despite the challenges this may entail, it is a necessary step. Zhang Tianning hopes to see a decrease in insurance company costs to alleviate the pressure on government subsidies, as otherwise a breaking point may be inevitable.
In addition to policy and cost changes in healthcare, individuals must adjust their insurance plans annually based on income, age, health conditions, and medication prices to fully benefit from this healthcare coverage.
For example, regarding dental services, Zhang Tianning mentioned that if a customer plans to receive dental treatment in the upcoming year, they should consider which insurance company offers the most benefits and convenient services when selecting their health insurance plan for the year ahead. As an insurance broker, tailored plans are created based on each customer’s unique needs.
Changes in medication prices require customers to review their insurance plans promptly. Zhang Tianning emphasized that medications are a significant expense for many retirees, possibly costing hundreds of dollars per month. Brokers offer multiple options for customers to choose discount medication plans based on their medical needs to save on expenses.
Changes in health conditions may necessitate adjustments to insurance plans. Zhang Tianning provided an example of patients undergoing significant health checks this year and subsequently requiring new coverage the following year. Switching health insurance plans allows individuals to allocate funds to areas where they are most needed.
Moreover, some patients may already have trusted hospitals or physicians. When selecting insurance plans and healthcare providers, it is essential to verify if preferred hospitals, doctors, dental, or eye care services are covered under the contract. While specific requests may lead to slightly higher premiums, choosing a plan should focus on customization rather than solely prioritizing price.
Some customers opt to do nothing by the year-end, in which case insurance companies typically maintain their previous plan automatically. However, this situation usually applies to individuals in excellent health who have not extensively utilized their health insurance throughout the year.
Zhang Tianning advises not to miss the Medicare registration period (from October 15 to December 7). Individuals nearing the age of 65 should remember to complete the Medicare enrollment procedure within the three months before turning 65 and the three months after to avoid potential financial penalties and increased premiums in their remaining years.