FARGO, N.D. • Beth West has spent more than two decades helping people with their insurance needs. As someone who knows the insurance business, she said there is some positive news for North Dakota.
For instance, more than one-third of Americans receive Medicare coverage through a comprehensive form of private insurance known as Medicare Advantage, or Medicare Part C, according to information from NextBlue. North Dakota, however, has been under-served with Medicare Advantage options.
That’s about to change.
NextBlue of North Dakota, an affiliate of Blue Cross Blue Shield of North Dakota, is helping North Dakotans do more with their Medicare by offering education and Medicare Advantage options. This has the potential to affect many thousands of people, including retirees or those getting ready to retire.
West, plan president of NextBlue of North Dakota, said more and more people are retiring early and will need insurance options.
“I think COVID has definitely escalated folks looking at retiring earlier, or kind of being forced into that,” she said.
NextBlue plans, which are Medicare Advantage plans, offer a number of benefits such as pharmacy benefits, a national provider network, and comprehensive supplemental benefits.
“It’s basically really helping folks who are aging into Medicare or in a current Medicare beneficiary determine what their options are,” she said, noting some of the benefits include dental, hearing, vision, fitness membership and over-the-counter medications, among others.
West, who said NextBlue of North Dakota was formed late last year, answered several questions during an interview with Prairie Business, sharing perspective and insight on what is around the corner for North Dakotans looking for insurance options.
What resources are available to guide those who take an early retirement?
It really depends. If someone is working in an organization for a long time, many times the employer or HR department can give them some insight into what their options are, whether they can carry their insurance with them for a period of time or, if they're of Medicare age, looking ahead and moving into some sort of Medicare-type of coverage as they move into retirement. In addition, medicare.gov has some great resources available to them. Local agents, health and insurance agents, licensed agents are good resources to help assess what options are out there to make an informed decision.
What are the biggest developments you're seeing right now?
I think what we're seeing is we've moved away from folks having retiree insurance coverage, like they did many years ago where you would retire from a company and you could continue under the plan for the rest of your life. If you wanted to pay for the premium or part of the premium of the plan, the employer would help cover that. Now, many employers can't sustain that coverage and so when you retire you're kind of out looking for your own plans … you weren't actively actually having to go out and find your own coverage, but that’s something that is definitely increasing.
What about Medicare Advantage?
Medicare Advantage has really become a lead product for Medicare for those retiring and becoming Medicare eligible because a Medicare Advantage plan t has a lot of similarities to what people are accustomed to under traditional commercial-type insurance plans; they're very similar in style, but Medicare Advantage plans tend to have a lot of extra benefits … so people can get things like dental coverage and eyewear and things like that. …
Medicare Advantage plans are popular nationally because people are accustomed to how they're designed, because of the co-pays and cost shares that people are accustomed to when they work. … Medicare Advantage plans are becoming such a sought after type of coverage because they usually have a lower premium. And their design is something familiar to people and have all of these extra benefits. Nationally, about 33% of those Medicare eligible are enrolled in a Medicare Advantage plan. In North Dakota we're only like 18.5%, and so there's not that many people taking advantage of it yet. That's kind of my personal mission, to introduce the value of these types of claims to folks here in North Dakota.
When is open enrollment and when do plans take effect?
The annual election period starts Oct. 15 and runs through Dec. 7 for an effective starting date of Jan. 1.
Where will Medicare Advantage be introduced in North Dakota?
It will be available first in five counties – Burleigh, Cass, Morton, Richland and Stutsman counties. COVID played a little bit of havoc with us setting up our plans for the upcoming year. We work with a lot of providers, hospitals and physicians across the state to set that up and with COVID, not being able to really get out there and have those discussions and dialogues, and so that’s part of the reason for our initial footprint in the five counties.
Is there any forecast when it will expand across the state? Also, about how many people do you expect will sign up this first round?
I don't know exactly how many counties will expand each year, but we're on a pretty progressive track and we want to be able to offer this to anybody in North Dakota and not be limited by certain county areas. And so the quicker, the better. … I will just say, in the future we plan to expand and eventually have coverage across the state. In this initial year, and in additional years, we expect to have a couple thousand numbers. It will just continue to grow year over year.
You have some busy weeks coming up. What’s next?
Right now we're really looking at ways in which we can get information about NextBlue, the value of Medicare Advantage and the value of our products out into the community. It's a little more complicated right now because of COVID, because you can't really gather in big groups … so we're doing a lot of advertising, a lot of direct mail, a lot of grassroots efforts. We’re trying to work with the senior centers and supporting them in whatever way we can. And we’re working a lot to virtually connect with people across North Dakota, in the five counties that we're currently serving. So really. we’re just preparing to actually enroll our first customers … and then help them have a great onboarding experience. And then we’ll actually begin planning for the next year almost immediately.
Is there anything else you would like to tell us about the insurance plan?
I think maybe the one thing I would mention ... is the type of Medicare Advantage plan for a person who is aging and retiring. In addition to having their health care coverage and extra benefits, these plans almost always have their prescription drug coverage included. … They're also very versatile, they can travel with you. I know folks here in North Dakota, a fair amount, tend to break (away for the winter). They like to get away, they like to go to the Caribbean or some place warm. These plans offer coverage for those things that are so important for folks, because otherwise with an original Medicare plan you really can't travel outside the country. You only have coverage if you buy a separate insurance plan.