Taking Advantage of Medicare Open Enrollment

Medicare Open Enrollment Period, October 15th through December 7th, can pay off in significant savings and/or significant additional benefits. Medicare Fall Open Enrollment Period is the time you can join, switch, or make other changes to Medicare drug and health plans.

In Medicare, individuals must choose one of two paths: original fee-for-service Medicare, or a federally subsidized Medicare Advantage plan, which typically operates like a health-maintenance or preferred-provider organization. Many who opt for traditional Medicare also purchase a private "Medigap" policy, as well as a separate prescription-drug policy, to patch holes in their coverage.

In recent years, Medicare Advantage plans have gained in popularity, in part because, when compared with a Medigap policy, they generally cover a wider array of benefits, often including prescription drugs and dental care. Many also charge lower premiums, but require members to use the plan's network of providers.  As previously reported on this Blog, Medicare Advantage premiums are estimated to decline to their lowest in 13 Years. 

How, then, should Medicare beneficiaries prepare for Open Enrollment? Here’s a checklist from The Senior Citizens League:

1. Review: By now, people covered by Medicare Part D or Medicare Advantage plans should have received an Annual Notice of Changes for 2020 from their current plan. In addition to changes to the premiums, the notice will explain increases, if any, in the deductible, copayments and coinsurance. The notice will tell you where to find information about the pharmacies in the drug plan’s network, and it will refer to “the drug list” or plan formulary of covered drugs which usually can be found online or requested from the plan. What the notice does not include is a list of the drugs you currently take, the tiers that your drugs will be on in 2020, whether coverage has been dropped for any of your drugs in 2020, or what those drugs will cost if co-insurance is charged.  Plans will provide most of that information, but it requires either calling your plan directly and speaking to someone who can estimate the cost of your drugs in 2020, or obtaining the advice and counsel of a professional, such as the professionals at Harding Harding & Associates, Inc., who will help evaluate your plan changes.  Once you have this information, it’s very important to compare all your health and drug plan options to find your lowest-costing coverage.
2. Gather and write legibly: Gather all of the drugs you currently take and carefully make a list, printing the name of the drug, dosage, quantity taken per day, and quantity required per month. Do this for each drug taken. Make sure your writing is legible. Type and print it out if possible. Keep this list on file where you can find it easily. Not only will you need it to compare drug plans, it’s handy to take with you on each visit to your doctor.
3. Get free, unbiased assistance from a Medicare counselor: You can get great help from a local Medicare benefit counselor who provides free one-on-one counseling through State Health Insurance Programs (SHIPs). Local contact information can be found at: https://www.shiptacenter.org. Call and make appointment now, because Open Enrollment will take more time than usual this year. The Medicare Drug Plan Finder comparison tool which counselors use to compare drug plans and estimate costs has recently been re-designed. “It’s likely to take longer than usual to sort through plans and determine the best choice for clients while all of us are learning how to use the new system,” Johnson says.
4. Narrow your choices and contact the prospective drug plans directly to confirm details: Once you have picked out three or so plans that look like your best bets, contact the plans directly to confirm the details. This includes coverage of all your drugs, estimated co-pays and co-insurance, which pharmacies participate and other questions you may have.
5. Switch plans by going through the Medicare website: It’s better to switch plans through the Medicare website than trying to do so directly with the insurer. This way Medicare will make sure your previous plan unenrolls you by the end of the year and your new coverage begins on January 1, 2020 with the new plan. Your SHIP Medicare benefits counselor can help you do this.

If you need help call 1-800-Medicare (1-800-633-4227) or contact your local area agency on aging to get free one-on-one counseling.

For more information: 

• Visit the Medicare website at www.medicare.gov, or call toll free at 1-800-MEDICARE (1-800-633-4227).
• Medicare Advantage Premiums Decline to Lowest in 13 Years With Open Enrollment Approaching.
• Preparing for Medicare Open Enrollment