Medicare Open Enrollment is an annual period of time (October 15 through December 7) when current Medicare beneficiaries can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs. This enrollment period provides the opportunity for beneficiaries to review their current plan, compare it to other plans on the market, and decide whether to keep their plan or switch to a new one.
With this year’s Open Enrollment Period just around the corner, time is of the essence. Medicare Open Enrollment is the only time period you can sign up for individual health insurance outside of special circumstances. If you miss the deadline, only a qualifying life event can trigger a special enrollment period. Otherwise, individuals must wait until next year’s Medicare Open Enrollment to make any changes to their Medicare Health Plan or prescription drug coverage.
“Even if you are confident that you want to keep your current coverage for 2019, it is important to make sure you understand any changes that may apply and that you have double checked to make sure that your current plan is still the best available option.”
For most Medicare beneficiaries, choosing health insurance is no longer a one-time decision. Each year, insurance companies can make changes to Medicare plans that can impact how much you pay out-of-pocket, through changes to your monthly premium, deductible, drug costs, and provider or pharmacy networks. They can make changes to your plan’s formulary (list of covered drugs) as well as change or drop benefits that were previously offered, like dental, vision, or hearing.
It can be very confusing to determine which health plans and prescription drug coverage options you have during Medicare Open Enrollment. Below is a list from the National Council on Aging’s My Medicare Matters of what you can do during the upcoming Open Enrollment Period (OEP).
- Anyone who has (or is signing up for) Medicare Parts A or B can join or drop a Part D prescription drug plan.
- Anyone with Original Medicare (Parts A & B) can switch to a Medicare Advantage plan (like an HMO or PPO).
- Anyone with Medicare Advantage can drop it and switch back to just Original Medicare (Parts A & B).
- Anyone with Medicare Advantage can switch to a new Medicare Advantage plan.
- Anyone with a Part D prescription drug plan can switch to a new Part D prescription drug plan.
When will my coverage begin?
New coverage will begin for all plans on January 1, 2019.
What if I like my current Medicare plan?
If you don’t want to make changes to your coverage for the coming year, you don’t need to do anything during open enrollment, assuming your current plan will continue to be available.
If your plan is being discontinued and is not eligible for renewal, you will receive a non-renewal notice from your carrier prior to open enrollment. If you don’t, it means you can keep your plan without doing anything during open enrollment.
Be aware, however, that your benefits and premium may have changed. Even if you are confident that you want to keep your current coverage for 2019, it is important to make sure you understand any changes that may apply and that you have double checked to make sure that your current plan is still the best available option. Remember, even if the plan you have now was the best option when you shopped last year, it is important to verify that again before you lock yourself in for another year.
How can I re-evaluate my plan to lower medical costs?
According to the National Council on Aging’s (NCOA) My Medicare Matters, re-evaluating your plan during open enrollment can help you identify potential significant savings and lower your medical costs, while keeping your current doctors, hospital, and pharmacy.
- You can save money on prescriptions. NCOA notes that using open enrollment to switch your drug coverage—or add drug coverage for the first time—can make the medications you need less expensive. It can also ensure that your drug plan still covers the medications you need (as your prescriptions may not be included on your plan’s formulary for 2019).
- You can save money by keeping your doctor in-network.Switching your Medicare Advantage or Part D plan can potentially save you hundreds of dollars a year—especially if your current plan’s out-of-pocket costs will increase next year. Research shows that the average consumer can save $300 or more annually if they review their Part D coverage. One way to lower your medical costs is to check that your current doctors, hospital, and pharmacy are “in-network” with whatever Medicare Advantage or Part D plan you choose. If your insurance company has changed your plan’s provider or pharmacy network for next year (and your doctor or other resources will no longer be included), you can use open enrollment to switch to a plan that will include your current doctors, hospital, and/or pharmacy in-network, thereby lowering your medical costs.
- You can find a higher quality plan.Check the quality of your plan using the Medicare 5-star rating system. Plans with a 5-star rating are considered high quality, and those with fewer than 3 stars are considered poor quality. If your current plan is ranked as less than a 3, consider using the Open Enrollment Period to switch to a higher rated plan.
I’m confused. Who can help me select the best plan for myself or a loved one?
You can find Medicare plan information or compare plans by calling 1-800-MEDICARE (1-800-633-4427) or visiting Medicare.gov.
In Ohio, you can also contact the Ohio Senior Health Insurance Information Program (OSHIIP), which offers free health insurance information and services for people on Medicare. Jewish Family Service of Cincinnati is an official OSHIIP site. Call AgeWell Cincinnati at 513-766-3333 to get information for yourself, your parents, grandparents, or other older family members and friends who are covered by Medicare.
How do I get help paying for Medicare prescription drug coverage?
If you have limited income and resources, you may qualify for Extra Help to pay your medical expenses. Visit socialsecurity.gov/i1020 to apply online. Or call Social Security at 1-800-772-1213 and ask for form SSA-i1020. TTY users can call 1-800-325-0778.
Remember, each year there are new health plans and prescription drug coverage choices. Take advantage of the upcoming Medicare Open Enrollment Period. Review your current health and prescription drug coverage and make sure your plan is still right for you.