Medicare Assistance

By John Salois

Avoid Medicare Mistakes during the Annual Election Period

For people who may want to change their Medicare coverage, they can make a change during the Annual Election Period (“AEP”) which runs from October 15th until December 7th. Any change you make during the AEP is effective on January 1st.

During the AEP people can:

Switch from Original Medicare (Parts A and B only) to Part C also called Medicare Advantage
Switch from one Medicare Advantage plan to another Medicare Advantage Plan
Switch from Medicare Advantage to a Part D prescription drug plan, or vice versa
Switch from one Part D prescription drug plan to another Part D prescription drug plan

Here are some common tips to be aware of:

1. Don’t assume your current plan isn’t changing.

Whether you are covered under a Medicare Advantage or Part D prescription drug plan, these plans change somewhat from year to year. Plan premiums, deductibles, co-pays, networks and benefits are all elements that insurance companies can and often do modify each year. Don’t make the mistake of thinking “I’ll just keep what I have” because what you have might just change on you!

2. Provider networks are top priority

Often Medicare beneficiaries choose their plan based upon the premiums, co-pays and extra benefits the plan is advertising. I always tell my clients that network considerations come first. If your doctors don’t accept the plan you have enrolled in, the extra benefits that the plan gives you will not help you very much.

3. Know your Rx Formulary

The word formulary is just a fancy way of referring to a plan’s prescription drug list. Each plan will have a unique formulary, deductible, co-pay tiers and pharmacy network. Just as it is important to make sure your doctor accepts your new plan, it is also important to make sure you have adequate prescription coverage based upon your current needs.

4. Be sure to work with an Independent Advisor

It is important to compare all the plans available in your area, so you can make an informed decision about your Medicare coverage for the upcoming year.

Independent Medicare Insurance Advisors are licensed insurance agents who certify annually to provide information and enrollment services with various insurance plans in your area. When you contact a specific insurance company directly, the agents that work for that company are only certified to provide information about the plans that their company offers, not those of competing companies. An Independent Medicare Insurance Advisor is certified with a multitude of plans and able to help you compare plans from different insurance companies and choose the plan that works best for your specific situation.

Also, what works for you today may not work for you next year. Your Medicare insurance needs may change over time and the benefits of the various Medicare insurance plans can change considerably from year-to-year too. An independent advisor will help you review your Medicare insurance plan needs during each Medicare Open Enrollment Period and make necessary recommendations for each upcoming calendar year.