5 Tips for Medicare Open Enrollment, Oct 15 – Dec 7

If you’re on Medicare, what do you need to do?

If you do nothing…you will continue with whatever plans you are currently in and subject to any changes for the new year. If there are changes to your current plan(s), you should have been sent a letter.

Here are the decisions you need to consider:

1. Are you in Original Medicare or in a Medicare Advantage Plan such as a Medicare HMO? It is important to know and understand the difference. With original Medicare, most people have a Medicare supplement to pick up Medicare gaps. With a Medicare Advantage Plan, you would not need a Medicare supplement policy but would be subject to certain rules and restrictions. Most Medicare Advantage plans also include prescription (Part D) coverage.

2. If you’re in a Medicare Advantage Plan, are you satisfied with it? If not, the open enrollment period is the time to disenroll but BE SURE that you can qualify for and afford to purchase a Medicare supplement; otherwise, you are at financial risk for the Medicare gaps (balances leftover after Medicare pays such as deductibles and co-insurance). For more information about Medicare Supplements (also known as Medigap) click here.

3. If you have original Medicare and a Medicare supplement, you will need to be in a Medicare Part D plan unless you have existing prescription coverage equal to or better than Medicare’s. There are multiple drug plans that contract with Medicare to offer prescription coverage. You must choose and enroll in a drug plan in order to have the prescription coverage. If you’re already a member of a Part D plan, you will automatically be renewed in the same plan (subject to any new changes) unless you choose otherwise. (Some people in certain situations, such as Medicaid recipients, are automatically enrolled in Part D.)

4. Do you have a Medicare Part D prescription drug plan, are you satisfied with it? Is the premium going up? Have your prescriptions changed since you first enrolled in your plan? If so you might want to compare and possibly consider a new drug plan for 2013. How? There is a good comparison tool on www.medicare.gov, or call Medicare 24/7 1-800-Medicare (800) 633-4227, your local State Health Insurance and Assistance Program, or your trusted pharmacist. You will need a list of your medications and Medicare card.

5. People on Medicare who are also recipients of low income and resources programs such as Medicaid, QMB, or “Extra Help” are not limited to making changes during the annual enrollment period. The same is true with patients in nursing homes but they still need to be aware of any possible changes for 2013.

For more information, visit www.medicare.gov or call Medicare’s help line 1-800-633-4227, 24/7.

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