Health

Medicare Open Enrollment – A Process That’s Worth Your Time

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As of October 15 (that’s right, it’s that time of year again) it’s another Medicare open enrollment period. It lasts until December 7th — an easy date to remember for those of us who are a little older. This is the time when we can reconsider how our Medicare supplemental or Medicare Advantage (MA) plans are working for us, and, maybe more critical, how our Part D prescription plans are working. If I’ve said it once, I’ve said it more than once, many of us pass up this chance to save ourselves a lot of money. Here are the dismal facts from past years: only 30% reviewed their supplemental insurance plans and about 50% reviewed their MA plans. Even more troubling, only about 20% reviewed their MA prescription drug plans and 30% reviewed their stand-alone drug plans. It is often the case that the way we can save the most money and get access to the particular prescription drugs we need is by choosing the drug plan that fits us best. I do realize that when our prescription drug plan is included as part of our overall plan, which is the case with most MA plans, you feel like you don’t have many options to change. That often isn’t the case. There are sometimes other drug plans to choose from or the option to opt out of the MA’s prescription drug plan and find your own stand-alone plan. It might even make sense to change to another MA plan with similar Medicare benefits but with a drug plan that fits you better. The key here is not to assume you are stuck. Find out about your options.

There are a couple of situations that are strong indicators that you should review your coverage. First, if you have had a change in your health, require new medicines or stopped taking some medicines, you need to explore your options. Expensive cancer treatments and medication are examples of situations that could require significant out-of-pocket costs. Auto immune diseases also often require expensive medicines. Even a small change can have a large impact on the bottom line. Second, a change in your insurance coverage may impact your access and cost. Your plan may decide that the doctors and specialists that you see on a regular basis are no longer in their preferred provider network. Suddenly paying out of network costs could have a substantial financial impact. The same goes for your prescription drugs, your plan may change the cost and even your access to the prescription drugs you currently take. It is important to review the 2024 plan descriptions that your current plan sends out this time of year to see if any of their changes affect you. There is one Important thing to remember: the insurance company has the option at the end of the year to completely cancel the insurance plan you currently have, and, if you don’t select a new policy by the close of the open registration period (December 7th), they can select a policy that, at their discretion, matches the plan you had before. While I see this happening more often next year when the full impact of the Inflation Reduction Act changes go into effect, it’s still a good idea to not get caught letting some other entity decide what’s good for you.

There are some preparations that you can do that will make it easier to do this once-a-year review. The first thing you need is a list of the medicines you take. Write out how much out-of-pocket you spend on each prescription and whether you expect to take them for all of next year. I’ve often mentioned that having a list of your prescription and non-prescription medicines and their dosage is a good thing to have with you. It seems that I fill out that information many times a year as I visit providers, over and over, it makes me crazy but it’s easier if you have the info easily available. Just recently, I was able to attach a copy of my medicine information when I checked in on-line prior to my appointment. If you keep track of your out-of-pocket costs as you create and update your list, you will have all the info you need when you review prescription drug plans during the open enrollment period. The second thing is to know what your yearly premiums, co-pays, max out-of-pocket, and coinsurance requirements are for your current plan. The last item you need is a list of the doctors and providers that treat you. This will be valuable when you review the list if providers that are considered in network for the 2024 plans.

While there are many things to consider, there is help available to get you through the process. The best way is to click here which takes you to Medicare.gov. If you haven’t already created an account, you can do it there. After you sign on, it will bring up information about your current plan. It’s also an excellent place to add or update the information they have with the info you gathered as outlined above. I would still keep a copy of your data, both digitally and in hard copy (I just don’t want a glitch in the government’s system to cause you to lose all your info). This plan finder tool will be a big benefit in showing you your options. Another help is your local State Health Insurance Assistance Programs (SHIP), which exists in every state. You can find how to contact them in your state and get help by clicking here. The good thing about these two sources is they are both unbiased. They aren’t trying to sell you anything. They aren’t perfect, and I would contact the plan itself once you narrowed down your choice just to confirm the facts.

Well, there it is, another chance to let you sleep soundly for another year knowing you have chosen the best plan for you . . . although for many of us, it takes more than that for us to get a good night’s sleep. Happy hunting!

Best, Thair

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