Get with the Plan - The Beacon

Get with the Plan

Get with the Plan

Fall Open Enrollment is the time of year when you can change your Medicare coverage by joining a new Medicare Advantage plan, joining a new stand-alone prescription drug plan (PDP), add a Medigap insurance policy, or return to Original Medicare with or without a stand-alone Part D plan.

Your BBB receives calls and visits to our web site concerning health insurance and health plans, especially during Medicare fall open annual enrollment from October 15 to December 7.

Learn more about Fall Open Enrollment choices. If you enroll in a plan during Fall Open Enrollment, your coverage starts January 1. In most cases, Fall Open Enrollment is the only time you can pick a new Medicare Advantage or Medicare Part D plan. If you have Medicare Advantage, you can also switch to Original Medicare. To get Medicare drug coverage, you must join a stand-alone Part D plan at this time.

Medigap policies are health insurance policies sold by private insurance companies. If you have a Medigap policy, Original Medicare first pays its share for your care, and then Medigap pays all or part of the remaining costs, including deductibles, coinsurance and copayments. Medigaps may also cover some health care that Medicare doesn’t cover at all. Medigaps only work with Original Medicare; not Medicare Advantage plans, and you may be limited in your ability to buy a Medigap during the Fall Open Enrollment period, depending on where you live. Click here for information on purchasing a Medigap.

Review your Current Medicare Health and Drug Coverage. If you have Original Medicare, take a look at next year’s “Medicare & You” handbook to know your Medicare costs and benefits for the upcoming year. If you are unsatisfied with your Original Medicare coverage, you can make changes to your coverage during Fall Open Enrollment. Changes made to your coverage will take effect January 1. If you have a Medicare Advantage plan or a stand-alone Part D plan, you should receive an Annual Notice of Change (ANOC) or Evidence of Coverage (EOC) from your plan. Review these notices for any changes in the plan’s costs, benefits and rules for the upcoming year. If you are dissatisfied with any changes, you can make changes to your coverage during Fall Open Enrollment. Coverage changes will take effect January 1 of next year. Even if you are satisfied with your current Medicare coverage, Medicare Advantage or Part D plan, another plan in your area may offer you better health and/or drug coverage at a more affordable price. Research shows that people with Medicare prescription drug coverage (Part D) could lower their costs by shopping among plans each year. For example, another Part D plan in your area may cover the drugs you take with fewer restrictions and charge you less. If you want to join a Stand-alone Prescription Drug Plan (PDP)

The Medicare.gov Plan Finder compares plans based on the drugs you need, the pharmacy you go to and your drug costs. If you want to join a Medicare Advantage plan, call 800-Medicare to find out what plans are in your area.

When you receive the list of plans, check the plan websites to see which best fits your needs. After you have researched a plan online, call the plan itself to confirm what you learned. Make sure the plan includes your doctors and hospitals in its network. Confirm that the plan covers all your drugs, and that your pharmacies are in the preferred network. Write down everything about that conversation. In your notes, record the date of the conversation, whom you spoke with, and the outcome of the call.

This information may help protect you in case a plan representative gives you misinformation. To assist you with understanding all of your Medicare coverage options, call or visit the website of your State Health Insurance Assistance Program or SHIP.

Enrolling in a new plan through Medicare by calling 800-MEDICARE is the best way to help protect you if there are problems. When you enroll through Medicare, write down everything about the conversation including the date of the conversation, whom you spoke with, and any information you were given during the call. Before you enroll with Medicare, confirm all of the details about your new plan with the plan itself. If you are dissatisfied with your Medicare Advantage plan, you can dis-enroll from that plan and join Original Medicare during the Medicare Advantage Dis-enrollment Period (MADP) every year from January 1 to February 14.

Finally, understand the difference between the Fall Open Enrollment Period and Open Enrollment for the Health Insurance Marketplaces, (also known as Exchanges.) They will hold open enrollment for uninsured or underinsured Americans. The Marketplaces are not meant for people with Medicare.

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About the Author

Michael

Michael is our Business Information Specialist and will be writing at least one article per week for the consumer education blog. He works with accredited businesses to ensure we maintain current contact information and licensing. He is usually first to answer the phone; so odds are good you will be speaking with him when calling our office.

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