Mark your calendars: Medicare open enrollment, officially called the Annual Election Period, ends in less than a month, on December 7. Whether you have original Medicare, Medicare Advantage or a prescription drug plan through Medicare Part D, now is the time to make sure you or your loved one has the right plan for the year ahead.
“A lot can happen in a year,” says Linda F. Fitzgerald, state president of AARP Massachusetts, which represents more than 800,000 members age 50 and older in the commonwealth. “You may have been diagnosed with a new medical condition, changed medications, or moved. There may also be changes to your Medicare plan. Now is the time to take a close look at your medical needs – including prescription drugs – and make sure you have the Medicare plan that’s best for you.”
During Medicare open enrollment, the Annual Election Period, people in Medicare should check their current Medicare plan, and, if necessary, switch to another plan. For example, a person might change from a Medicare Advantage plan back to Original Medicare, switch Medicare Advantage plans, or join a prescription drug plan.
Not sure where to start? Try following the four “C’s”: coverage, cost, convenience, and customer satisfaction.
- Coverage: Comparing Medicare plans can be simple. The official Medicare website has a tool at www.Medicare.go/find-a-plan that helps you compare all of the plans available in your area. When reviewing plans, focus on the benefits, such as coverage offered while in the prescription drug coverage gap, or “doughnut hole.” Also, find out which drugs are covered.
- Cost: From year to year, Medicare plan costs may change. During open enrollment, compare all of the costs, including premiums, deductibles, drug costs, and out-of-pocket maximums.
- Convenience: When it comes to going to doctor’s appointments and filling prescriptions, convenience matters. When reviewing Medicare plans, find out if access will be available to your doctors, or doctors nearby. And, check that the local pharmacy accepts the plan, and that the plan provides online prescription-filling or mail-order options.
- Customer service: When comparing plans, take note of Medicare’s star-rating system. Medicare health and prescription drug plans are rated on how they perform in different categories, such as responsiveness and care, member complaints and customer service. A plan may rate between one star (“poor”) and five stars (“excellent”).
After reviewing the four “C’s,” it is time for the “D” – decide. Keep in mind: Even if your current Medicare plan has worked well, it is wise to evaluate the options since the open enrollment period is the one and only time each year when people in Medicare may switch plans.
For further assistance, Massachusetts residents who need help figuring out their Medicare options should contact SHINE (Serving the Health Information Needs of Elders), a free program that provides insurance counseling. Call toll-free 1-800-AGE-INFO (1-800-243-4636) or contact the local Council on Aging or Senior Center.
For a free copy of AARP’s free guide, Understanding Medicare, visit www.aarp.org/ma or call 1-866-448-3621 (reference the publication title and D19327).
dennis byron
8:42 am on Wednesday, November 21, 2012
This article can be misleading to senior citizens. This one isn't as bad as many of the articles I see but still people on Medicare -- and people under Medicare age -- have to be careful of subtle parts of the Medicare law, especially as changed by Obamacare, to make sure they don't have to spend more money than necessary on their health care.
Here's one example. The author begins the article above by saying:
"Mark your calendars: Medicare open enrollment, officially called the Annual Election Period, ends in less than a month, on Dec. 7"
Well, the reason is its "officially called the Annual Election Period" and not Medicare open enrollment is because now is NOT Medicare open enrollment time. Medicare general enrollment happens in January-March of each year. Medicare general enrollment time is the period when people who did not sign up for Medicare when first eligible can sign up for the first time. There aren't very many of us seniors in that category but that is why it is not correct to say that now is "Medicare open enrollment time."
What is happening now is that people ALREADY SIGNED UP for Medicare A and/or B can elect to add or drop or change their Part C and Part D Medicare health and drug plans.
One change seniors might consider is dropping their Part C plans because Obamacare has drastically changed how they are going to work. Like all Obamacare, this is not fully in effect for a few years. But you might want to plan ahead (see separate comment).
dennis byron
8:44 am on Wednesday, November 21, 2012
One question seniors need to start thinking about is whether this is the year to drop their Part C Medicare Advantage and go to Medigap/Part D because of the coming changes to Part C Medicare Advantage caused by Obamacare. Or whether to wait a few more years, put the likely savings in your pocket, and see how bad the Obamacare-related changes are. The Medicare actuary projects either or both major premium increases and major benefit reductions to Part C Medicare Advantage because of Obamacare over the next five years.
But Obamacare makes changes to Medigap too -- either or both elminating the kind of first-dollar coverage we in Massachusetts get in Medigap Supplement 1 (e.g., Medex Bronze) or punishing seniors for buying such a plan. One reason to switch to Medigap now (but remember you'll also have to get a Part D standalone drug plan) is that seniors on Medigap now may be grandfathered in to the better Medigap features that are going away under Obamacare.
Someone that waits to switch will typically save money now but will possibly pay more later as the features of Medigap and Part C Medicare Advantage are basically aligned so that one type of plan is the same as the other. One example of that is that Obamacare is going to automatically put everyone on Medicare into an "accountabe care organization" (has already begun in Massachusetts for about 100,000 seniors) and that will really be no different than being in a Part-C-Medicare-Advantage-health-plan-type HMO or PPO
dennis byron
8:44 am on Wednesday, November 21, 2012
Here's another subtlety that you never see in the press. Don't be scared by the millions of words in the press about the Part D standalone drug plan "donut hole."
People from insurance companies such as AARP quoted in this article hype the "donut hole" in order to sell you more insurance coverage than you need. The reality is that nationwide only about 5% of Medicare beneficiaries fall into the donut hole. And only about 1% of us seniors actually go all the way through it.
The press' hype about the donut hole is even more harmful than that. No poor seniors anywhere in the United States are ever affected by the donut hole and they get free Part D premiums and they get their drugs with nominal co-pays with no deductibles. ("Poor" is measured by both income and assets.)
So the "donut hole" as small an issue as it is statistically is mostly an issue for the few middle and upper income seniors affected by it. That's no comfort to you if you do fall in the hole I understand but in Massachusetts there's some good news for you seniors in the middle income brackets. It's called the Prescription Advantage state pharmaceutical assistance program and it can take a lot of the sting out of the costs and in the middle income brackets and has not asset test