Oct. 15 is the official start of open enrollment for Medicare and Medicare Advantage and you should take stock of your situation before signing up for your 2017 plan.
Before you get started this year on either renewing your plan or opting for a new one, there are steps you can take to make sure that you get the plan that is best for you and that fits your budget and meets your expected medical needs for the year.
- Understand the open enrollment period
Open enrollment runs from October 15 to Dec. 7, 2015 for Medicare Advantage (Part C) or Medicare Prescription Drug Coverage (Part D), and it’s also the time you can make changes to an existing plan, switch plans and change drug coverage.
- Review your plan notice
You should have already received your “Annual Notice of Change” letter from your Medicare plan about changes for next year. Two of the most important things to look at are to make sure your drugs are still covered and ensure your doctors are still in- network.
- Evaluate your needs
Because Medicare health and drug plans change each year, you need to stay on top of changes to your plan. Also, your health needs change, as well as your age. You may want to ask yourself, when evaluating different plans:
- If you need a new primary care doctor.
- If your network includes a specialist you want for an upcoming surgery or procedure.
- If your new medication is covered by your current plan or if current medications will be covered by next year’s plan.
- If there is another plan that offers the same benefits at a lower cost.
You may also want to schedule a checkup before deciding on next year’s plan. Take stock of your health status and determine whether you need to make a change.
- Find a plan that meets your budget
You can use Medicare’s plan-finder tool at Medicare.gov to evaluate the plans available to you. Here are the areas you should consider when looking for a plan that you can afford:
- The cost of the premium.
- What are the co-pays, and which drugs are covered – and at what cost.
- Find a plan that includes your preferred doctors and pharmacy.
If you find that your current coverage still meets your needs, then you’re done. If not, you’ll need to evaluate which one you can afford while ensuring it meets your needs.
- Medicare or Medicare Advantage?
If you collect benefits from Social Security, you will automatically get Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).
Remember: There is a premium for Part B. If you are covered through active employment or by your spouse’s insurance, you must follow the directions when you get your Medicare card indicating you don’t want it.
If you are going with original Medicare, you have the option of adding Part D prescription drug coverage, which will better control your medicine expenses.
Or choose a Medicare Advantage (Medicare Part C) plan that bundles original Medicare with extra benefits and may include prescription drug coverage in one plan. Medicare Advantage is akin to an HMO or PPO and you will have to see doctors that are in the insurer’s network or pay higher co-pays if you go outside the network.
- Understand deadlines
If you miss the enrollment deadline, you may have to wait until next year before you make changes.
However, there is a second enrollment period – from Jan. 1 to Feb. 14, 2017 – during which you can drop a Medicare Advantage plan and switch to original Medicare.
If you do, you can also sign up for Part D prescription drug coverage.