Steph Insure
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Most people are underinsured and don't know it ๐
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Having a chronic health condition may be part of qualifying for certain Medicare Advantage supplemental benefits.
But having the diagnosis alone may not be enough.
Some benefits for things like healthy foods, utilities and other everyday expenses may be offered as Special Supplemental Benefits for the Chronically Ill, often called SSBCI.
To qualify for these benefits, Medicare requires more than simply having a qualifying chronic condition.
A person must also be at high risk for hospitalization or other adverse health outcomes and require intensive care coordination.
And the specific eligibility criteria can depend on the plan and the benefit being offered.
So two people who both have diabetes, heart disease or another chronic condition shouldnโt assume theyโll automatically qualify for the same benefits.
Thatโs why I donโt want you making decisions about your 2027 benefits based on what you had last year, what a friend receives, or even a diagnosis by itself.
Check your specific plan. Check the eligibility requirements. Ask questions.
I created a 2027 Medicare Allowance Benefit Checklist to help you know exactly what to look for.
Comment CHECK and Iโll send you a copy!
๐ฉ Get my free Medicare help here: https://go.stephinsure.com/start
Before we compare a single Medicare plan for 2027, I want five things on the table.
Literally, if we're meeting in person. ๐
1. Your prescription list
Names, dosages, and how often you take them.
2. Your doctors and specialists
Especially the ones you absolutely do NOT want to give up.
3. Your preferred pharmacy
Because where you fill your prescriptions can affect what you pay.
4. Your current plan information
We need to know what you have now before we can decide whether something else actually works better for you.
5. Your ANOC
This shows us what's changing with your current coverage for 2027.
Why do I want all of that before we start looking at plans?
Because we're not trying to find the plan with the longest list of benefits or the prettiest brochure.
We're trying to figure out what makes sense for your actual life and healthcare needs.
And the more we know before we start comparing, the better questions we can ask.
I made this part easy for you. ๐
My 2027 Medicare Plan Review Checklist has a list of what to gather before your review, plus the things we'll want to check while comparing your options.
Comment CHECKLIST and I'll send you a copy.
๐ฉ Get my free Medicare help here: https://go.stephinsure.com/start
If you use a Medicare Advantage allowance for things like healthy foods, utilities or other eligible expenses, you want to pay attention to this for 2027.
Some of these benefits have specific eligibility requirements, and simply having a chronic condition doesnโt necessarily mean youโll qualify for a particular benefit.
That matters because it can be easy to think:
โI have this benefit now, so Iโll have it next year too.โ
But Medicare Advantage plans and supplemental benefits can change from year to year. Your plan may have different benefits, amounts, eligible uses or requirements for 2027.
So before you count on that allowance for groceries, utilities or another expense next year, there are a few things worth checking:
๐ Is the benefit still offered by your plan?
๐ Do you meet the eligibility requirements?
๐ Has the amount or frequency changed?
๐ Can you still use it for the same things?
๐ Are there any new rules or restrictions you need to know about?
You donโt need to sort through all of that alone!
I put together a 2027 Medicare Allowance Benefit Checklist to help you know exactly what to check and what questions to ask.
Comment CHECK and Iโll send you a copy.
If your healthcare had a 2026 highlight reel, what would be on it?
Maybe youโฆ
๐ฉโโ Started seeing a new doctor or specialist
๐ Added or changed a prescription
๐ฅ Had a procedure you weren't expecting
โ Traveled more than usual
๐ฐ Had a healthcare cost that surprised you
Those things tell us something.
Because reviewing your Medicare coverage isn't only about asking, "What's changing with my plan?"
It's also about asking:
What's changed with ME?
Take a quick look back at how you actually used your healthcare this year. It can tell you a lot about what matters for next year.
๐ฉ Get my free Medicare help here: https://go.stephinsure.com/start
You can take the exact same prescription, with the exact same Medicare drug coverage, to two different pharmacies...and potentially pay two different amounts. ๐Yep.
Where you fill your prescriptions can matter just as much as whether they're covered.Some plans have pharmacies where your prescriptions may cost less than they would at another in-network pharmacy.Which means when you're looking at your drug coverage for 2027, don't just ask:"Is my medication covered?"
Also ask:"What could I pay for it at the pharmacy I actually use?"And if the answer makes you raise an eyebrow, it may be worth checking whether another pharmacy could make more sense.This year especially, it's important to have an accurate prescription list AND know which pharmacy you prefer so you have the information you need when reviewing your drug coverage.
That's why both are included in my 2027 Medicare Plan Review Checklist.Comment CHECKLIST and I'll send you a copy.
๐ฉ Get my free Medicare help here: https://go.stephinsure.com/start
You checked your hospital and it's in-network. Great! ๐But I don't want you to stop there.Because the hospital building isn't the only thing that matters.Think about the people you actually see for your care.Your cardiologist. Your orthopedic doctor. Your oncologist. The specialist you've been seeing for years and absolutely do NOT want to start over with.Those are the names we need to check too.
Because a plan can include the hospital or health system you prefer without necessarily including every doctor or specialist you see.
And finding that out AFTER you've already changed your coverage is not exactly the kind of surprise we're looking for. ๐ฌThat's why, when we're looking at your options for 2027, I don't just want to know, "Is my hospital in-network?"
I want to know:Does this coverage work with the doctors and specialists I actually rely on?If keeping a particular doctor is important to you, send me a message with their name. Let's make sure we're checking the people who actually provide your care, not just the name on the hospital building.
๐ฉ Get my free Medicare help here: https://go.stephinsure.com/start
Here's a Medicare number that's changing for 2027: $2,400.That's the new annual out-of-pocket threshold for covered Part D prescription drugs, up from $2,100 in 2026.So...what does that actually mean for you?
If you take expensive medications and your out-of-pocket spending on covered Part D drugs reaches that threshold, you move into catastrophic coverage and don't pay additional cost sharing for covered Part D drugs for the rest of the year.But here's the part I really want you to know:
This doesn't mean everyone with Medicare is going to spend $2,400 on prescriptions next year.Your actual costs depend on your medications, your plan, where you fill your prescriptions, and other factors.And THAT'S why your prescription list is such an important part of reviewing your coverage.Don't just look at the plan premium. Let's look at what YOUR medications could actually cost you.
If prescription costs are one of your biggest concerns going into 2027, send me a message! We can take a closer look at your specific situation.
๐ฉ Get my free Medicare help here: https://go.stephinsure.com/start
"My prescription is covered, so I'm good...right?"Maybe. But I have a few more questions. ๐๐ผโโ๏ธ
Seeing your medication on a plan's drug list is a great start, but it doesn't tell you everything you need to know.
โข What tier is it on?
โข What will you actually pay for it?
โข Does the plan require prior authorization before it will cover it?
โข Is there step therapy, meaning you may need to try another medication first?
โข Is there a quantity limit on how much the plan will cover at one time?
โข And could filling that exact same prescription at a different pharmacy change what you pay?
THAT'S why we don't just search for the name of your medication, see a little checkmark, and call it a day.
The details can affect both your wallet and how easy it is to actually get the medication you need.I included all of these things in my 2027 Medicare Plan Review Checklist so you know what to look for when you're reviewing your prescriptions for next year.
Comment CHECKLIST and I'll send you a copy.
๐ฉ Get my free Medicare help here:
https://go.stephinsure.com/start
Your ANOC showed up.
Before you file it away in the very official "I'll deal with this later" pile ๐, there are three things I want you to look at.
1. What you'll pay.
Look for changes to your premium, deductible, copays, and other out-of-pocket costs. Even a change that looks small can matter if it's attached to care you use regularly.
2. Your benefits.
Check whether benefits you actually use are changing for 2027. Don't get distracted by everything the plan offers. Pay attention to what matters to YOU.
3. Your prescription coverage.
Look for changes to the drug coverage information included with your plan materials. A medication being covered this year doesn't automatically tell you how it'll be covered next year.
You don't need to memorize your ANOC or understand every line of it.
But you DO want to know what's changing before you decide whether your current coverage still works for you in 2027.
And if you get to page two and your eyes have already glazed over, send me a message. ๐
I'll help you figure out which changes actually matter for you.
Start here: https://go.stephinsure.com/start
Do you have both Medicare and Medicaid? A rule just changed for D-SNPs โ the plans built specifically for people with dual coverage โ and it's the kind of update that's easy to miss until it affects you.
Dual-eligible coverage already means juggling two programs instead of one. When the rules shift behind the scenes, even quietly, you don't want to find out the hard way that something changed.
If this is you, it's worth a real conversation before assuming your plan is staying the same.
Know someone with both Medicare and Medicaid? Tag them below โ this is exactly the kind of thing they'd want a heads up on.
๐https://go.stephinsure.com/start
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