Medicare – Open Enrollment Period Starts Soon – PART 2

For any of us, things can change in ways that might affect how we can best participate in Medicare. For example, if you are enrolled in a Medicare Advantage plan, the insurance company may make changes to the plan. Or your situation may have changed—your budget, health status, travel plans, or place of residence, for example. That’s why Medicare offers enrollees an annual opportunity to update the coverage choices they’ve made and start the following year with an updated coverage plan.

During the annual open enrollment period you may:

• Move from regular Medicare (Parts A and B) to a Medicare Advantage plan (Part C) . . . or, the other way around, from Medicare Advantage to regular Medicare.
•  Change from one Medicare Advantage plan to another.
•  Add, change, or drop coverage in a Part D prescription drug plan.

Medicare Advantage changes

If you are currently in a Medicare Advantage (Part C) plan, here are some things to watch for during your review window:

• Changes in the plan’s provider network: will you be able to continue seeing your preferred providers?
• Cost increases: will you have to pay higher premiums, deductibles, or co-pays?
• Changes in the plan’s prescription drug coverage: will the medications you take still be covered?
• Additional benefits: is your plan introducing, continuing, or ending any benefits, like dental, vision, hearing, or fitness membership? Is there a competing plan with a better package of such options?

Personal considerations

Consider changes that may affect your own needs and priorities. For example:

• Your health status: do you expect to require more health care services or new and expensive medications?
• Choice of providers: are your current primary physician and specialists still in your plan’s provider network?
• Travel plans: will you be spending time in another state or country, and how will coverage work if you need care while you are away?
• Cost considerations: is your goal to reduce your expenses by finding lower premiums, deductibles, or co-pays, or by saving through better drug coverage?
• Lifestyle changes: have wellness benefits, like a gym membership, become more important to you?
• Consumer satisfaction: are there cost or performance reasons you would like to explore alternative plans?

If you have Medigap insurance

Medigap insurance is private health insurance coverage that supplements Medicare benefits (for those not in a Medicare Advantage plan) by covering some of the out-of-pocket costs not covered by Parts A and B, such as copayments, coinsurance, and deductibles. Purchasing or making changes in Medigap coverage is not restricted to the annual Open Enrollment Period, but other state or insurer limits may apply. But if you are using the open enrollment period as an opportunity to review and consider changes to your Medicare participation, it makes sense to also review your Medigap insurance options while you’re at it.

A resource if you have questions

Every state offers its SHIP (State Health Insurance Assistance) Program. This is a national program that offers free, confidential, and unbiased counseling and assistance to Medicare beneficiaries and their families. SHIP counselors are trained to help individuals understand their Medicare options, compare plans, and resolve issues related to Medicare coverage. You can find contact information for your state’s SHIP program at www.shiphelp.org, or call the national SHIP helpline at 1-877-839-2675.

Good luck taking full advantage of this year’s opportunity to revisit and possibly make changes to your Medicare coverage options.