INSURANCE

Q: This is my first full year on Medicare. What do I need to know about the fall Open Enrollment period? A: Medicare’s Annual Open Enrollment Period is the time of year when you can make changes in your Medicare coverage. It begins on October 15 and ends on December 7.

During Open Enrollment, you can change from Original Medicare to a Medicare Advantage (Part C) plan or vice versa; you can join or switch from one Medicare Advantage plan to a different Advantage plan; you can switch or drop a Medicare Prescription Drug (Part D) plan. The changes you make during Open Enrollment will become effective January 1, 2021.

Before Open Enrollment begins, you will receive information from Medicare and your insurance company explaining any changes in your coverage for 2021. Take some time to read through this information. If you are happy with your current plan, you do not have to do anything. You will automatically be re-enrolled.

However, if your health has changed, or you switched to a new doctor, or your prescriptions have changed, your plan may no longer be the best choice for you in 2021. Here are some things to check:

1. Are your doctors, hospitals, and other health care providers in your plan’s network?

2. Has your prescription coverage or costs changed? Are the plan’s preferred pharmacies the ones you use? Has your plan added any new hurdles before your medications are covered?

3. Has your premium, co-pays or deductible increased?

4. Has your plan added benefits that make it more attractive? Some Advantage plans now offer transportation for medical appointments, allowances for nonprescription medical items, meal delivery after hospital stays, and other wellness programs.

5. Will you be in the market for routine vision, dental or hearing coverage in 2020? Original Medicare does not cover these while some Medicare Advantage Plans do.

6. Will you be facing any major medical issues requiring expensive treatment or the possibility of a long-term hospital stay? Medicare Advantage Plans have a maximum on what you pay out-of-pocket annually while there is no yearly limit on your out-of-pocket medical costs with Original Medicare.

One last point: Do not assume a plan that meets your needs will be the best one for your spouse. You may be better off choosing different plans for the two of you.

I represent many of the most respected insurance companies and can help you find the best plan for you. Contact me at 440-255-5700 or Lmutsko@mutskoinsurance.com to set up an appointment during Open Enrollment.