With Annual Enrollment just around the corner, seniors everywhere are reviewing their Medicare plans to see if they need to make changes to their coverage. If you’re new to Medicare, you may be wondering where to start, and how to make sure you are enrolled in the right plan to fit your needs and your budget.
Review Costs and Benefits for Next Year
As a recipient of Medicare (Part A and Part B), you should take the time to look over next year’s costs and benefits to see if Medicare will still work for you. Review your Annual Notice of Change, which should arrive by mail in October. If you are not happy with what you see, Annual Enrollment (October 15-December 7) is the time to make changes. Remember, any changes you make during Annual Enrollment will take effect on January 1 of next year.
Check You Prescription Drug Formulary
If prescription medication is a significant part of your medical care, be sure to check the formulary for next year to make sure your needs will still be met. Many times, the list of covered drugs changes from year to year. You need to know if your drug is no longer available or will change tiers and become more expensive. This applies to Medicare Part D, as well as prescription drug coverage you may have with a Medicare Advantage plan.
Review Changes in Networks With a Medicare Advantage Plan
Many times, benefits and costs stay the same with Medicare Advantage, but networks change from year to year. Be sure to confirm that your doctor is still part of your plan’s care network and that any hospitals you use are still available under the plan. Of course, it’s smart to review a few new plans in your area to see if the same coverage is available at a lower cost to you. If your Medicare Advantage plan includes prescription drug coverage, don’t forget to look over next year’s formulary for changes to drugs, dosage amounts, and pharmacy availability.
Annual Enrollment Does Not Apply to Medicare Supplement Plans
If you have Medicare Supplement insurance (a Medigap policy), Annual Enrollment does not apply. Any changes you wish to make to your plan are best made during your unique Medicare Supplement Open Enrollment period. Open Enrollment begins the first month you turn 65 and enroll in Part B. During these six months, you have a guaranteed issue right, meaning no insurance company can turn you down or charge you more for a plan. After your Open Enrollment period ends, insurance companies may refuse to sell you a policy and can charge you more for the same policy. If you have a pre-existing health condition, make changes to your policy during your Open Enrollment, as you may not be able to get a plan after it ends. Luckily, if you miss your enrollment period, there are a few exceptions and you may have a guaranteed issue right in some situations. If, for instance, you move out of your plan’s service area or you have Original Medicare and your employer coverage is ending, you will likely have a guaranteed issue right to buy a new policy.
Resources:
https://www.medicare.gov/supplement-other-insurance/when-can-i-buy-medigap/when-can-i-buy-medigap.html#collapse-2283
https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-help-others/Medicare-Open-Enrollment.html
https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/when-can-i-join-a-health-or-drug-plan.html#collapse-3190
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