Las Vegas Review-Journal (Sunday)

What’s possible during Medicare annual enrollment?

- TONI KING Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@ tonisays.com or call 832-519-8664.

Dear Toni: This is my first Medicare annual enrollment period, and I don’t know anything about this process. How do I find out which options are best for me? I have some health problems and I’m concerned about making a change. Which Medicare health plan and prescripti­on drug plan do I choose? Will I have to answer health questions to qualify? — Frank, San Antonio

Dear Frank: During Medicare’s annual enrollment period, Oct. 15 to Dec. 7, the Toni Says team is asked this question at least 20 times a day.

Which Medicare option is right for you depends on your health and financial situation. You may be someone who has a history of serious health issues requiring expensive brand-name prescripti­on drugs or who goes to the doctor once a year for a physical and takes inexpensiv­e generics. Take your time and research your options.

Here are steps the Toni Says team uses when helping clients during the annual enrollment period:

1. Decide if you want original Medicare (Parts A and B) or a Medicare Advantage plan (Part C).

■ Ask your doctor’s office which plan is recommende­d. Most doctors accept original Medicare, but not all accept Medicare Advantage plans. If your doctor is in a Medicare Advantage plan’s provider directory, make sure you call to verify that the office is still accepting that specific Medicare Advantage plan.

■ The main difference between original Medicare and Medicare Advantage plans is that original Medicare works only with Medicare, and the Medicare supplement pays the deductible­s or coinsuranc­es (or you pay, if no supplement­al policy is selected). Medicare Advantage plans are also called Part C. They are administer­ed by private insurance companies that are approved by Medicare and are primarily HMO and PPO plans.

■ When choosing a Medicare Advantage plan, you must use that specific insurance company’s card, not your Medicare card.

2. Decide if you need to enroll in or change your current Medicare Part D plan during the annual enrollment period.

■ If you want Medicare prescripti­on drug coverage to go with original Medicare, then you must enroll in a stand-alone Medicare Part D plan, which will carry a monthly premium.

■ If you choose a Medicare Advantage plan, make sure that the plan has Medicare Part D prescripti­on drug coverage included, to keep from receiving a Medicare Part D penalty for not enrolling in a Medicare prescripti­on drug plan.

■ Verify that all your prescripti­ons are covered.

3. Remember, you have from Oct. 15 to Dec. 7 to change your Medicare Advantage plan or standalone Medicare Part D plan to begin Jan. 1.

■ If you miss the Dec. 7 deadline, you will have to wait until next year’s enrollment period.

■ The annual period is only for enrolling or changing your Medicare Advantage prescripti­on drug or Part D plans. You can change your Medicare supplement, long-term care or dental plans anytime of year.

Take your time during Medicare’s annual enrollment period to explore your options.

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