Tips to help you navigate Medicare open enrollment
We are in the midst of the Medicare Annual Open Enrollment Period (AOEP); Oct. 15 to Dec. 7, 2016, when Medicare beneficiaries have the option to change their Medicare plans to better meet their needs in 2017. Open Enrollment is the time to make changes to Medicare Advantage (HMO, PPO, PFFS) Plans and Part D Prescription Drug Plans. Some retiree plans also conduct Option Selection Periods to coincide with Medicare’s AOEP. If you have a retiree plan, follow the instructions for making changes from your plan.
It is common for Medicare Prescription Drug Plans and Medicare Advantage Plans with drug coverage, to change their formularies, or list of covered drugs each year. These changes to coverage were sent to you sometime during September by your current plan in notices called Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC).
By Sept. 30, you should have received the ANOC and EOC from your current plan outlining the 2017 details of the plan.
Your plan may no longer cover all of your drugs in 2017, or your drugs may change to a more expensive Tier, or there may be other changes that make your current plan less cost effective for you. If this is the case, you may want to see if there is a better option. You are given the Annual Open Enrollment Period to enroll in a new prescription drug plan. Changes made during Open Enrollment will be effective Jan. 1, 2017. Do not assume that what you selected last year will remain the same, or that it will be the best for you in 2017.
Critical factors to consider when choosing a new Part D plan are (1) cost, (2) whether all of your medications are on the plan’s formulary and (3) whether your pharmacy is participating as a preferred network pharmacy or a standard costsharing pharmacy. If you would like to try using the Medicare Plan Finder, here are a few tips from The Medicare Rights Center to facilitate your search.
The Medicare Rights Center http://www.medicarerights.org/ states in one of their recent newsletters:
“You can find a new Part D plan by using the Medicare Plan Finder, an online tool at www.medicare.gov that can be used to compare stand-alone Part D plans or Medicare Advantage Plans with prescription drug coverage. Plan Finder provides information about costs, including monthly premiums, deductibles and copayments, which drugs are included on the plan’s formulary, and the star rating of the plan.
“To use Plan Finder you will need to go to www. medicare.gov and click on the green button that says ‘Find health and drug plans’. You can do a general search by entering a zip code, or you can do a personalized search by entering more information, such as your Medicare number and date of birth. Next you can enter the drugs you take and choose the pharmacies you like to go to. Plan Finder will display results for plans that cover your drugs and have your pharmacies in their networks. Note that a plan may not cover all of the drugs you take, but it may have alternatives on its formulary. Plan Finder also tells you if the plan has a deductible and how much the monthly premium is. It is a good idea to call the plan directly to confirm any information you read on Plan Finder, as information may not be completely up to date. You can enroll in a plan online, or by calling 1-800-MEDICARE, or by calling the plan directly.
“You can make as many changes as you want between Oct. 15 and Dec. 7, but only the last change you make will take effect on Jan. 1, 2017. If you choose a plan and realize that it is the wrong plan after Fall Open Enrollment is over, in most cases you will not be able to change your coverage until the next Fall Open Enrollment Period. For this reason, it is important to carefully consider all of your options and take the time to make the right decision for your health care needs. “
While noted above, you can call the plan or Medicare to enroll in a new plan. The Chester County APPRISE program is local and counselors can help you navigate this process. An APPRISE counselor can help you enroll in a plan that might provide better coverage and have lower premium. The counselor can also screen you for any assistance programs that could help you better afford your Medicare and possibly lower the cost of your drug coverage.
So, what can you do between Oct. 15 and Dec. 7? You can make changes to your present Medicare Advantage Plan or your Prescription Drug Plan using the tools on www. Medicare.gov. If your situation is more complicated or you do not feel comfortable working online, an APPRISE state-certified counselor will be able to assist you. APPRISE counselors will be available at senior centers, several libraries and other locations throughout the county during this time period. To make an appointment, leave a message at 610-344-5234 or you may call a senior center directly. You can also email us with questions at email@example.com.
The Chester County Department of Aging, through its APPRISE program of trained Medicare counselors, helps Medicare beneficiaries to understand the health care options specific to their health needs and financial resources. This is one in a series of articles prepared by APPRISE volunteers to help Medicare beneficiaries navigate this complex system. APPRISE is a free, confidential and unbiased service provided by the Pennsylvania Department of Aging, and locally under the auspices of the Chester County Department of Aging.