You may have noticed a lot of advertisements lately about the Medicare Open Enrollment Period that is available for Medicare participants from October 15 – December 7. These announcements urge everyone with Medicare coverage to use this time to review their plans to see what new changes are coming in the new calendar year. The Open Enrollment Period is when Medicare participants can change from one plan to another. This is very important if you are either not satisfied with your current plan or your medical needs have changed and you need more coverage.
If you only have Original Medicare Parts A and B, there is no maximum annual out-of-pocket limit to costs that you are responsible to pay. While this may not be an issue if you are in good health, it can be a big consideration if you have an ongoing chronic condition such as arthritis, heart disease, lung problems, or diabetes. Additionally, you have to pay for Medicare Part D to have coverage for prescription medications. Therefore, it is worth your time to see what additional Medicare benefits you are eligible for and which Medicare Advantage Plan, known as Medicare Part C, best meets your needs. Now is the optimum time to make changes to your Medicare coverage.
It can be confusing to review all of the available Medicare availability plans to find the one that is best for your personal needs. When considering a change from Original Medicare, or from one Medicare Advantage plan to another, you can cut through all the printed information by talking with a licensed Medicare insurance agent. An agent is able to compare the plans that you are eligible for and to help you identify a plan that fits within your budget, meets your medical and dental needs, and can be used when you travel outside of your local area.
Whether you review your options on your own or you seek the help of a Medicare insurance specialist, be sure to make a list of issues that are important to you. Some additional Medicare benefits are only available in certain zip codes. These benefits can include rides to medical appointments and gym membership in the Silver Sneakers exercise programs. If these benefits are important to you, be sure to research their availability in your area or ask your Medicare insurance agent.
Here are five of the most common concerns that Medicare participants want to know more about.
1. Healthcare Providers: If you are like most people, you already have a doctor, or several doctors, that you both like and who accept Medicare insurance. If you make changes to your Medicare coverage, be sure to check on whether your providers are still accepting Medicare insurance plans and that they are still listed as in-network providers. Many Medicare Advantage plans will require that you use in-network healthcare providers.
2. Monthly Costs: If you are enrolled in Original Medicare, you already know what you are paying each month for Part B. You may also be paying for a Medigap plan and/or Part D for prescription medications. You want to compare these costs with a Medicare Advantage (MA) plan monthly payment that covers everything in Part A and Part B and includes additional benefits, such as Part D. Additionally, MA plans have annual limits on out-of-pocket costs. You may find that a Medicare Advantage plan offers more benefits at a lower cost, or at no additional cost than you are currently paying.
3. Prescription Coverage: Unfortunately, good health is not a guarantee. Health issues tend to increase as we age. Most ongoing health issues often include the need for prescription drugs. Consider having prescription coverage when you want to make changes to your Medicare coverage. Because the cost of prescription drugs changes from one year to the next, having this benefit will save you from expensive out-of-pocket costs. If you currently have Part D coverage, check to see if your medications are still on the approved drug coverage list. If your prescription is not going to be covered, contact your health care provider for alternate medication.
4. Vision and Hearing Coverage: Original Medicare has strict regulations on what types of vision and hearing coverage are permitted. Usually, these benefits are connected with other health issues. Many Medicare Advantage plans include vision and hearing benefits when you use in-network providers.
5. A Plan that Travels with You: Original Medicare is valid across the country by all health care providers and facilities that accept Medicare. Be sure to check if your desired Medicare Advantage plan can go with you as you travel around the country. This is an important consideration if you are thinking about moving to a new home that is outside of your current state.
Bottom Line
The OEP, from October 15 – December 7 is the timeframe to make changes in your Medicare coverage. Don’t let this opportunity to get the coverage you need for the lowest cost. Waiting for next year’s Open Enrollment Period can make the difference between living within your budget and having to face large out-of-pocket expenses. Take advantage of consulting with a licensed insurance agent who will work with you and your list of concerns to find the plan that’s right for you.
Related articles:
Five Reasons to Choose Medicare Advantage(Opens in a new browser tab)
When Can I Change My Medicare Supplement (Medigap) Plan?(Opens in a new browser tab)