Time to Review Your Medicare Coverage

 

Sometime in late October, I’ll host the 12th Annual Friends of Elaine Kortzeborn Medicare Open Enrollment Party.

Every year since 2005, I’ve helped a dozen or so of my mom’s buddies review their Medicare Part D prescription drug insurance and make sure it still works for them.
At first, I ran into some resistance. Mom’s friends didn’t want to bother. They had coverage and didn’t see why they needed to keep checking their drug plans. After a couple of years, though, that attitude disappeared.

We kept finding that, every year, their health needs changed and so did the list of drugs covered by their plans. Shopping among the numerous plans and choosing the right one could mean saving hundreds of dollars a year.

Now, everyone’s on board to make sure they have coverage that’s right for them. All this is just my way of reminding you that Medicare’s annual open enrollment season began Oct. 15 and runs through Dec. 7. This is the time every year when you can sign up for a new Medicare drug or health plan, or switch the one you have now. Any new coverage you select will take effect Jan. 1, 2017.

In addition to Part D drug plans, open enrollment applies to Medicare Advantage health plans, which are essentially managed care plans run by private insurers approved by Medicare.

If you have Original (traditional) Medicare and you’re satisfied with it, you don’t need to do anything during open enrollment. 

If you have a Medicare Advantage health plan or Part D drug plan, keep in mind that these plans can make changes each year, including what they cover, how much they charge for monthly premiums and deductibles, and which doctors, hospitals, and pharmacies are in their networks.

Always review the materials your health or drug plan sends you, like the “Evidence of Coverage” and “Annual Notice of Change.” Make sure your plan still meets what you anticipate will be your health needs for next year. If you’re satisfied with your current plan, and your insurer is still offering it in 2017, you don’t need to make any changes.
Here are resources to help you compare your current coverage with new plan offerings for 2017. You can:

  • Visit www.medicare.gov to review drug and health plans, including costs, available in your area and enroll in a new plan if you decide to. This information will be live on or around Oct. 1 (and before that on www.cms.gov.) Medicare rates the plans on a scale of one to five stars. Open enrollment information also is available in Spanish. 
  • Call 800-MEDICARE (800-633-4227) for around-the-clock assistance to find out more about your coverage options. TTY users should call 877-486-2048. Counseling is available in a variety of languages.  
  • Review the Medicare & You handbook. This handbook is mailed to the homes of people with Medicare each fall and it’s also online at www.medicare.gov/pubs/pdf/10050.pdf
  • Get free, unbiased, one-on-one counseling from your local State Health Insurance Assistance Program (SHIP). Local SHIP contact information can be found at www.medicare.gov/contacts/organization-search-criteria.aspx. You can also find this information on the back of the Medicare & You handbook or by calling Medicare (at the 800 number above).  

People with Medicare who have limited income and resources may qualify for Extra Help to pay for their Part D drug plans. There’s no cost or obligation to apply for Extra Help, and it can save you thousands of dollars each year. Medicare beneficiaries, family members, or caregivers can apply online at www.socialsecurity.gov/prescriptionhelp or call Social Security at 800-772-1213 to find out more. TTY users should call 800-325-0778.

 

 

 

Cate Kortzeborn is Medicare’s acting regional administrator for Arizona, California, Hawaii, Nevada and the Pacific Territories.