Dear Marci,
When does Fall Open Enrollment start, and how can I make sure I’m prepared? This is the first year I’ve had Medicare, so I don’t know what to expect.
– Zoe (Boise, ID)
Dear Zoe,
Fall Open Enrollment runs from October 15 to December 7 and is the time during the year when you can change the way your Medicare health coverage is delivered. Specifically, you can decide whether you receive your coverage through Original Medicare and a stand-alonePart D plan OR through a Medicare Advantage Plan. You can make as many changes as you like during this period, but only the last one will take effect. Any changes you make will become effective starting January 1, 2016.
Even if you decide you don’t want to change your coverage, it is still a good idea to take a look at your current health care coverage and see if it will continue to meet your needs in the coming year. Sometimes plans change their provider networks, policies, drug formularies, and/or preferred pharmacies, and sometimes your health care needs change as well. There are two important things you should do during Fall Open Enrollment:
- First, review your current health and drug coverage. If you have Original Medicare, take a look at next year’s Medicare & You handbook to know your Medicare costs and benefits for the upcoming year. If you are dissatisfied with your Original Medicare coverage, you can make changes during Fall Open Enrollment.
If you have a Medicare Advantage Plan or a stand-alone Part D drug plan, you should receive an Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC) from your plan. Review these notices for any changes in the plan’s costs, benefits, and rules for the upcoming year. If you are dissatisfied with any changes, you can change your Medicare Advantage Plan or stand-alone Part D plan during Fall Open Enrollment. If you want to switch from a Medicare Advantage Plan to Original Medicare you can do that as well at this time.
Remember: even if you are satisfied with your current Medicare coverage, it’s smart to look at other Medicare options in your area that may better suit your individual needs in the upcoming year. Particularly if you think that you may need specific health services or drugs in the coming year, you should make sure your health insurance will cover them.
- Next, think about costs. It is important to look at the different premiums and deductibles associated with the plans you are considering. Some Medicare Advantage Plans have an additional premium on top of the Part B premium of $104.90 that most beneficiaries pay each month. Similarly, some drug plans have annual deductibles, while others do not. This is all to say that it is a good idea to compare all aspects of the plans you are considering. For example, even if you are satisfied with your current Medicare Advantage or Part D plan, you should check to see if there is another plan in your area that will offer you the same or better health and/or drug coverage at a more affordable price or have fewer coverage restrictions. Research shows that people with Medicare prescription drug coverage could lower their costs by shopping among plans each year.
Take action! Create a list of all the health care providers you see, prescription drugs you take, and pharmacies you use. Contact your SHIP for one-on-one assistance with reviewing your health and drug plan options for 2016.
– Marci