ABOVE: Kim Garbers of Fairmont National Agency Insurance looks over health insurance paperwork at her office. Garbers said for the 350-400 Medicare clients she represents, costs look to be heading upward next year on all parts.

FAIRMONT – Heading into next year, local health insurance agents say there will be fewer options and higher costs for the insured and less support for the work that agents do.

There are 350 to 400 people on the books of Agent and Owner of Fairmont National Agency Insurance Kim Garbers, all of whom are on Medicare. Her son, Anthony Garbers, helps in Fairmont and runs his own business, Garbers Insurance, in Wells. He has around 350 on MNSure and 100 on Medicare.

Kim said they meet people where they’re at and help them throughout the process.

“Most of the people come here have no clue,” she said. “They’ll tell me so and so said this, or my brother has this, or this person said this. The problem is they don’t have the same problem. They don’t have the same health issues. You really need to look at each individual to see what health issues they have. Are they good on an Advantage plan, where you have lots of co-pays? Would they be better off on a supplement plan?”

Over the last few years, cost and what plans cover is what she said have been the biggest changes.

“They’re covering less, as far as drugs,” she said. “They’ll have a little pool of drugs that do the same thing. Let’s say you have 30 different brands of inhalers. They will pick two out of there they’ll cover, and the rest they won’t. Pretty much everything used to be covered under Medicare. They just took care of you. It’s not quite that easy anymore.”

When it comes to what brings people in that they hear about on the news, Kim said people are trying to get their premiums down as much as they can. In some cases, such as a family business with five people on one plan, she’s finding that very challenging to do.

“I’m looking for a better plan for them, and right now it would be $9,600 a month if they went to Blue Cross Blue Shield,” she said. “That’s $100,000 a year for a very small business. How can you do that? The other one is through Medica, and that one is $7,200. It’s still a lot. What can I do to protect their family? The most important thing is, what can you do for them and have it affordable enough for them to handle?”

Recently, it was announced that UCare will be shutting down and transferring all of its current enrollees to Medica, according to MPR News. For those with Medicare Advantage plans, Kim said the options are continuing to shrink.

“The UCare Advantage plan is gone,” she said. “Humana is here, but it’s really not taken anywhere. Now you’re down to two. You can do the Medica or the Blue Cross and Blue Shield.”

On the other side, Kim said industry changes are putting pressure on agents as well.

“They stopped paying agents, so agents don’t get paid for Advantage plans anymore, and they don’t get paid to help with Part D, other than a few very minor companies,” she said. “When I called my broker and I asked what was going on in the industry, what are these other places doing that have mostly these kinds of products that he just said, probably 90 percent will be out of the business.”

Part D of Medicare is for prescription drug coverage, and ranges from an additional $5 to $100 a month. In just the last year, Kim said the number of options for insurance through Medicare Part D has gone from 23 to 10.

“That’s pharmaceutical costs [going up],” Anthony said. “They can’t put a plan together to sustain value.”

With the withdrawal of support for agents working on Part D and potential thinning of options, Kim said that’s leading to people looking to go through the work themselves. For those that do, Anthony said it will be no small task.

“We spend 30 hours a year to take a government test, money out of our pocket to take that test, additional money if we want credit for taking that test, and then go to each and every company we represent and have to take a test to make sure that we are competent enough to help people with this on the Medicare side,” he said. “Now they think that it’s fine, they can do it on their own, that they really are pushing to have them just go online and do it themselves.”

Bottom line, on the individual and family health insurance side, Anthony said cost will likely go up between $50 and $250 a month because all the companies are increasing their premiums to cover costs.

“I had five clients last Monday doing this kind of stuff, and all five probably averaged $100 increase per person,” he said.

On the Medicare side, Kim said it is likely to increase as well. Part B is looking to increase from $185 a month, where it is now, to $205 a month.

“They’re on a very fixed income, and with the taxes going up and everything else going up, you know, I worry a lot about these seniors,” she said. “How are they supposed to be getting more money, right? The drug plans are going up as well.”

One positive Kim noted is some of the highest-costing drugs will be sold at a better price. For those in that boat, the increase won’t be as severe.

Through all of it, Kim said she could have retired a long time ago, but has seen no reason to do so.

“I have the best people out here,” she said. “I really feel that even if we don’t get paid, I have to help them. It’s not about the money, it’s about taking care of them, and sometimes you just have to do that, whether you get paid or not. You have to help these people.”

If people have concerns about costs and the effects it will have, Kim encouraged them to get in touch with their legislators.

“Say, enough,” she said. “I write to them, I call them, I try to email them with what’s going on. I wish more of my clients knew how involved the state is to every single thing, or the federal government is to everything that happens. Write the letters, contact your legislative people, let them know.”