Shopping for Medicare Coverage

By on November 15, 2016
Categories: TIPS & TRICKS

It’s Medicare open enrollment season again.

If you are a Medicare enrollee or are eligible for Medicare for the first time, you can shop for coverage from now until Dec. 7.

Reviewing your coverage can potentially save you hundreds of dollars or more in premiums and out-of-pocket costs.

During the open enrollment period, you can make these changes:

  1. Switch from original Medicare to Medicare Advantage, a type of Medicare plan offered by private health care companies, such as Kaiser Permanente.
  2. Move from Medicare Advantage to original Medicare.
  3. Switch from one Medicare Advantage program to another.
  4. Switch from one Medicare Part D prescription drug plan to another.

Also, individuals who did not enroll in Medicare Part D when they were first eligible can do so during the general open enrollment period although a later enrollment penalty may apply.

Even if you would like to keep your Medicare coverage for the next year, it’s important that you understand the changes that may be in store for your plan. Medicare plans often change each year so the best option for you last year may not be the best for you this year.

Unfortunately, most Medicare recipients do not compare available plans during the open enrollment period. A recent study by the Kaiser Family Foundation revealed that just 10 percent of seniors enrolled in Medicare Advantage checked their coverage options. The research concluded that many individuals don’t compare options because they think they are all basically the same.

In addition, a low percentage of seniors review their Medicare Part D prescription coverage. Another study by the Kaiser Family Foundation showed that enrollees could save an average of five percent on their premiums by switching plans.

Beyond the potential savings, there is another excellent reason to examine your Part D plan.  These plans routinely change the list of medicines (formularies) that they will cover.

The Part D plans can also change the rules governing payment for approved drugs. For example, the plan may decide to restrict the quantity of medicine that a patient can obtain or require a lot of paperwork to get an approval. The plan may also require a patient to try cheaper alternatives first.

Getting Medicare Help

Picking plans can be confusing, but there are respected resources to help. Here are three to check out:

You can obtain free advice through nonprofits called State Health Insurance Assistance Programs (SHIPs). Each state has a SHIP and you can find the contact information here.

You should also check out the Medicare Plan Finder at the Medicare website. You can type in your Medicare number and the drugs you use, along with the dosage, and the tool will list plans that can meet your need along with their premiums, deductibles and estimated costs.

The Medicare Rights Center, a nonprofit consumer group, has a hotline (800-333-4114) that can answer questions about your Medicare options.


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