Medicare Open Enrollment Tips & FAQs

When is Medicare Open Enrollment

Open Enrollment began October 15 and ends December 7. Changes are effective January 1, 2017. Open Enrollment isn't the only enrollment period during the year. There are others and we'll cover those in an upcoming blog post.

What does it mean?

Open Enrollment means you can change your Medicare drug plan or Medicare Advantage Plans (HMO or PPO).

Do I have to do anything with my Medicare Supplement Plan during this period?

No. It's auto-renewed.

If I’m already in a Medicare drug plan, do I HAVE to do anything? 

No, you don’t have to if saving money is not important to you. If you are happy with your existing plan, and it is offered next year, you will automatically be renewed. 

If I’m already in a plan, SHOULD I do anything?

Yes, you should. If you are in a Medicare drug plan and cost is important to you, it is very important to compare the costs of your current plan with the new plans offered each year. There are approximately 25 plans and costs vary widely. For example, the costs to purchase three common drugs--Lisinopril, simvastatin, levothyroxine--can vary widely. The lowest annual cost is $269  and the highest is $1,703. That's a difference of $1,434 for the year ($120/month)! Most people don’t realize this. That's why it's so important to compare plans every year.

Total cost of prescriptions can also vary depending on the drug store. For example, the lowest cost plan ($269 per year) is achieved when using Walgreens because that drug plan is co-owned by Walgreens. Costs for the same drugs at Kroger would have been $521. We're not saying that Walgreens is cheaper than Kroger across the board; it all depends on your drugs and the drug plan. The only way to know is to do an individual analysis based on the drugs you currently need. 

How can I can get help?

All of the following can help you comparison shop and complete the enrollment process:

  1. If you're use the Internet, the best tool by far is at www.medicare.gov. Once you're on the site, click on the green “FIND HEALTH & DRUG PLANS” button. 
  2. If you prefer to do things by phone, call the Medicare help line at 1-800-Medicare. It's available 24/7 and the sooner you call, the better.
  3. Visit a local State Health Insurance Assistance Program (SHIP) counselor for free, one-on-one, Medicare assistance. To access SHIP in Middle Tennessee, call (877) 801-0044.
  4. Go to your local drugstore and ask the pharmacist for assistance. 
  5. If you're an Elder Law Practice client, our staff is available to answer your questions.   

What do I need to do go get ready?

Assemble the following:

  1. A list of the drugs you currently take along with dosages
  2. Your drug store preferences
  3. Your Medicare card

If I enroll in a new plan, do I have to contact the old plan to cancel?

No, the cancellation is automatic. You will be sent a new card.

I’m in a Medicare Advantage Plan. What do I need to do?

First, look back at 2016. How did your Medicare Advantage Plan work for you this year? Did you understand the rules? Are your providers in the network? Did you have a lot of copays? Do you know and agree with any changes to your plan? Most include drug coverage, but make sure you know. 

Second, use the Medicare internet tool or help line compare plans. On the Medicare website, Medicare Advantage Plans are called “health plans.” You might want to consider the following: 

  • Is it HMO? PPO? Make sure you know the difference.
  • What is the deductible?
  • What are the copays?
  • What is the annual out-of-pocket limit?
  • How do the drug costs compare? 
  • What extra services are offered (e.g. YMCA, vision, dental)?

If you see a plan you think you like better, and you want to use certain providers, make sure those providers participate in the plan. Enrollment can be done on-line, just like drug plans.

Final Tips

If you’re thinking about enrolling in a Medicare Advantage Plan for the first time, seek out education and counseling in order to make an informed decision. Also, if you're switching from a Medicare Advantage Plan to original Medicare, you will probably want to purchase a Medicare supplement plan, so you might want to check on that first to see if you qualify and how much it would cost. Also, you will need to choose and enroll in a Medicare drug plan (unless you have creditable coverage from another source).

 

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