Each year, Medicare open enrollment brings with it changes that can affect nearly 50 million people. The limited enrollment timeframe of just 54 days – Oct. 15 to Dec. 7 – gives all Medicare beneficiaries the opportunity to change their Medicare plans for the coming year to better match their needs and potentially save on health care costs. This includes anyone using original Medicare, Medicare Advantage or Part D prescription drug plans.
If your Medicare coverage worked well during the previous year, it may seem simple to continue with those existing Medicare plans.
But there are many reasons why this annual enrollment season should grab the attention of Medicare beneficiaries, according to Paula Muschler, manager of the Allsup Medicare Advisor. This is a Medicare plan selection service offering personalized help that includes customized research and enrollment assistance.
“In the broadest terms, your Medicare plans may have changed what they cover, or your own needs may have changed, or both,” Muschler said. “If you continue with the same plan next year, you could find your plan doesn’t cover things you thought it did or that you need, leaving you holding the bill.”
Muschler outlined the following six reasons why beneficiaries should review their Medicare plans during the annual open enrollment season.
Your health situation has changed. Perhaps you have developed a health condition in the previous 12 months that requires a new prescription drug or ongoing visits to a specialist. It’s important to know whether the plan you have, or decide to purchase, covers these health needs.
Your health care provider situation has changed. Physicians may retire or relocate, and medical facilities may change their terms. A number of developments could lead your plans to no longer include the doctors you see or the medical center you visit.
“If your doctor choice is important to you, this is a good reason to study your options and possibly switch Medicare plans,” Muschler said.
Your coverage changes. Plans can alter the drugs, procedures and conditions they cover. For example, your prescription drug Part D plan may no longer cover the prescription drugs you need to purchase in the coming year, or put restrictions on how and where you purchase them.
“Questions about prescription drug costs are one of the top concerns our Allsup Medicare specialists encounter,” Muschler explained. “This is especially critical for those who fall into the prescription drug donut hole.”
The donut hole is the gap of coverage in which the individual pays a greater percentage of the drug cost.
Your plan premiums, co-pays or deductibles are increasing. Price changes occur year to year, so examine the prices you have been paying and what you can expect to pay in the coming year. There may be alternative plans with lower costs available in your area that an experienced Medicare specialist like Allsup can locate.
You have moved or are planning to move. It’s important to consider your Medicare plans when moving because you may leave the plan’s service area or have additional options.
Your current plan no longer will be available. In these instances, beneficiaries must select a new plan, or they may default to another plan chosen by the Centers for Medicare & Medicaid Services.
“Sometimes plans are eliminated because the provider offers a similar plan, but it’s still important to compare that coverage to what you actually need in the coming year,” Muschler said.
Each fall, Medicare participants receive their Annual Notice of Change and Evidence of Coverage from their Medicare Advantage and Part D providers.
“It’s important you read this information,” Muschler said. “Take time to review your current health care needs, and then compare this to the plan’s coverage for the coming year.”
“Reviewing your Medicare plan options earlier rather than later will put you in a better position to make changes during the annual enrollment window,” she said.