It’s Medicare open enrollment time — MEDI can help

It is that time again — the time to remind anyone who wants to review or change their Medicare coverage that Medicare Open Enrollment is here. The Annual Open Enrollment Period for 2022 coverage runs from Oct, 15, 2021 to Dec. 7, 2021. This year free health insurance counselors are available through the MEDI (PA Medicare Education and Decision Insight — formerly known as APPRISE) program at multiple locations throughout the state and specifically throughout Chester County. Most appointments this year will be by phone.

Here is how you can obtain additional information and/or schedule a free appointment. Note that if you are in a county other than Chester County, you can call 1-800-783-7067 to connect to your county’s PA MEDI.

For Chester County residents, you can log in online for information, by checking https://www. chesco.org/477/PA-Medicare-Education. To contact Chester County PA MEDI AOEP Helpline directly, call 610-344-5234. You can also call to schedule an individual appointment at the Chester County Government Services Center at 610344-6035 and additional call locations are located at several senior centers throughout the county.

For email send your email to smilam@chesco.org.

This is some of what you need to know.

If you are now on a Medicare Advantage Plan and would like to know your options to switch or if you have a Medicare Supplement but have prescription drug coverage under Medicare D, Medicare Open Enrollment is the time when decisions are made regarding certain Medicare plans for the next year.

You may have already received or you can expect to receive many glossy flyers from health insurers that often do not help in decision making. Recognizing this can also be a reason to reach out to volunteer counselors such as MEDI.

First, if you are confused, this is natural. The choice of insurance plans is frequently complicated.

Second, decisions will not always be based on the cost of monthly premiums.

As to prescription drugs you want to consider the drugs you are using and expect to use and their tier or whether they are considered specialty drugs.

For health coverage you want to know you are covered and what you would pay for serious illness.

Generally speaking, a Medicare Supplement plan may have certain advantages over a Medicare Advantage plan especially if you might move or become seriously ill.

If you are happy with what you have and are currently on a Medicare plan you may be just fine. This is a time to examine, not necessarily to change.

Before making any decision, recognize what kind of plan you are on. If you are 65 or over, for instance, and especially if you still work full time for a larger employer it is quite possible the employer’s plan is primary and Medicare is secondary and you do not need to make any major decisions at this time.

If your coverage is through yourself individually, know whether you have basic Medicare only or basic Medicare and also a Medicare Supplement (Medigap) or if you have a Medicare Advantage plan. It is not always easy to tell. Medicare Supplement plans are typically described by letters. If you have letters associated with your plan like G, H, N, etc. it is probably a Medicare Supplement (look at your insurance card). If you have benefits like dental, vision or Silver Sneakers, it is probably a Medicare Advantage plan.

Once you know whether you

have a Medicare Supplement or a Medicare Advantage, here are some of the considerations.

Sometimes individuals sign up for Medicare Advantage plans recognizing the premiums are often lower. When the same individual becomes seriously ill, he or she may discover that their Medicare Advantage plan is limited or is not accepted by certain doctors or hospitals. Medicare Advantage plans are limited to a given geographical area. So, if you have a plan in Pennsylvania and move to Ohio, for instance, you may need to apply for a different plan. Medicare Supplement insurance is accepted by any doctor or hospital that accepts Medicare.

Later, if you already have a Medicare Advantage plan and want to change to a Medicare Supplement, you may need to pass medical underwriting to qualify for the Medicare Supplement.

If you are confused, get help. The Chester County MEDI program staffed by volunteers and free of charge, is excellent.

Janet Colliton, Esq. is a Certified Elder Law Attorney from the National Elder Law Foundation recognized by the Pa. Supreme Court and the American Bar Association and limits her practice, Colliton Elder Law Assocs, PC, to elder law, special needs, guardianships, estate planning and estate administration with offices at 790 East Market St., Suite. 250, West Chester, colliton@collitonlaw. com. She is a member of the National Academy of Elder Law Attorneys and, with Jeffrey Jones, CSA, cofounder of Life Transition Services, LLC, a service for families with long term care needs.