Stay Informed and Save: Tips for a Successful Medicare and Drug Plan Open Enrollment Season

The six-week season runs between Oct. 15 and Dec. 7 each year and is the time for Medicare enrollees to evaluate their coverage and make changes where necessary in preparation for the coming year. Making good use of the season is the best way to ensure your Medicare and drug plan matches your healthcare needs.

Unfortunately, wading through the intricacies of the Medicare plan can be challenging. That’s why we’ve put together this post for you. We’ll discuss important tips to save you money and headaches over the next year.

Understand What You Can and Can’t Change

During the open enrollment season, you can switch to a Medicare Advantage (MA) plan if you are on Original Medicare (and vice versa).

You can also switch from your current MA plan to a different one. For example, some people switch from an MA plan without prescription drug coverage to one with the coverage.

This window is also the time to join, leave, or switch to a Medicare Part D prescription drug plan or a new private insurer.

However, switching from an MA plan to Original Medicare may not be practical. 

Evaluate Any Changes to Your Current Plan

One of the first things you should do before or during the Medicare and Drug Plan Open Enrollment season is to find out what has changed with your existing coverage.

Most plans send an Annual Notice of Change (ANOC) around September.

When reviewing the changes, pay more attention to:

• The list of drugs your plan will cover in the coming year
• How much the drugs will cost
• Your premium for the coming year
• The percentage the plan will cover for various medical expenses you may incur

Check with Your Doctors to See What Plans They Will Accept in the Coming Year

Talk with your doctors to confirm that they will accept your existing plan in the new year. If they are dropping your plan, you need to check those they support to see if they are affordable for you and if you can switch to them.

If you’re on Part A or B Original Medicare, your doctors will likely support the plan. However, it’s still a good idea to check. You need to pay a premium for Part B Original Medicare, but it still doesn’t cover everything.

If you have a Medicare Advantage plan, you should check with your physicians to ensure they are still in your plan’s network. If they are no longer on the network, you need to find out which one they now belong to. Going out of network while on an MA plan is generally very expensive.

Compare Your Existing Plan with Your Health Needs

The best way to make the most of the Medicare and Drug Plan Open Enrollment season is to compare the existing plan to your current health needs. You also need to consider any future healthcare needs you’re aware of right now. For instance, if you have a renal disease, what happens in the event of kidney failure?

If you’ve received a recent diagnosis and the existing plan will no longer cover your medications, you may need to switch to a new one. When exploring Medicare plans to switch to during the enrollment season, be sure to check the following:

• Coverage for prescription drugs. Medicare drug coverage will vary depending on your plan. Check out the plan’s provisions on what drugs are eligible. Are there any differences between generic and brand-name drugs?

• Travel coverage. If you intend to travel abroad next year, you should confirm that your plan will provide coverage if you need health services. Original Medicare will not cover overseas treatment. You may need to take on supplemental insurance in this scenario.

• Out-of-pocket costs. For any plans you’re considering, check the premiums, deductibles, copayments, and other payments not covered by Medicare.

Use Open Enrollment Resources

Whether you’re considering retaining your existing plan or thinking about switching to a new one, use the resources available to find the most cost-effective option. The State Health Insurance Assistance Program (SHIP) provides free counseling to all Medicare recipients.

The Senior Resource Center also provides guidance to Medicare enrollees looking to take advantage of the season.

Avoid Medicare Scams

Licensed or illegal Medicare agents publish numerous ads around this season. Avoid them. You should be wary of any Medicare personnel making unsolicited contact via call or text. 

You don’t want to fall for any scams that will leave you out of pocket or tie you to a health insurance program you don’t need.

Start Your Medicare and Drug Plan Open Enrollment Season Early

It’s easy to procrastinate when it comes to taking advantage of the open enrollment season. However, starting early allows you ample time to evaluate your options. Failure to take advantage of the window could mean waiting another year while enrolled in a suboptimal plan.

According to KFF, too many people fail to take advantage of the open enrollment. In 2020, only three in ten Medicare program enrollees reported comparing their current coverage with other plans before making a decision.

Make the Right Choice This Medicare and Drug Plan Open Enrollment Season 

With another Medicare and Drug Plan Open Enrollment season upon us, it’s another opportunity to ensure you have a cost-effective healthcare plan. Your choices within this window can have far-reaching effects on your healthcare and finances.Any mistakes may lead to a significant hole in your retirement plan.

At Senior Resource Center, we understand that finding the right coverage might feel overwhelming. Also, accepting assistance from insurers may feel like receiving a Trojan horse. Therefore, we offer consultation services and also provide the guidance you need to navigate the Medicare landscape.

Call Senior Resource Center in Austin, TX, at (512) 835-0963 to schedule a consultation today.