Medicare’s Annual Open Enrollment Period (Oct 15 – Dec 7) is upon us again. So what is the big deal? Why is this time period so important to those on Medicare plans? Simply put, each year a majority of the plans have subtle changes to the premiums, the medical coverage, and most importantly, the prescription drug formularies. An annual review is essential when it comes to avoiding the dreaded “donut hole.”

For the average user, changes to coverage affect copayments and coinsurance. The changes are especially “felt” by the user during continued services and prescriptions in the form of out of pocket costs. The “bottom line” is that the amount of money you spend for health care service and prescription drugs may change during the upcoming year even if services have not increased nor decreased. For many seniors, that means changes to their fixed monthly budgets. The end result is increased out of pocket costs and possibly a change to how you receive care (possibly trying different doctors, networks or clinics).

Open Enrollment is the opportunity to review any changes and possibly prevent problems with your Medicare health care service for the next year. Despite the complexity of Medicare plans and the moving pieces, qualified agents that sell Medicare Advantage Plans, Part D Prescription Drug Plans, and Medigap policies should be well versed in any changes and offer free reviews to ensure your plan is still the best fit for you. If you discover that the current plan is not your best option for the year, a change can be made quickly and effortlessly.

Which type of meeting should I attend and with which provider?

Each provider offers a variety of times and locations for General Medicare Enrollment informational meetings. The same providers offer individual and group product presentations that will feature all of the plans being offered next year within their portfolio. There are other nonprofit services and insurance brokers who are appointed with all Medicare providers and therefore can explain every plan at once. Researching new plans is an investment of time. To ensure that you get the best plan for your needs, it is important that your agent is knowledgeable about all of the plans and is unbiased concerning specific health care providers.

Should I Research Online or Not?

Another research option is to go directly online to www.Medicare.gov where you can enter your prescription drugs and find the best plans for the coming year. If you are not technology savvy, however, this method often confuses more than helps. It will provide options for health care plans with prescription drug plans, without drug plans, and stand-alone prescription drug plans. Most people will want to select Medicare health care plans with prescription drug plans. You can also phone them directly but be prepared for long hold times.

Medicare Rules to Keep in Mind

Remember, if you make a change to your coverage during Open Enrollment, the plan will not take effect until January 1, 2015. You may select multiple plans during Open Enrollment but the final plan received by Medicare will be the one that will be in force in 2015. If you have a Medigap plan you can always change your Part D without affecting your Medigap coverage. If you have prescription drug coverage through the VA, you may continue to receive your prescriptions from the VA. Those with VA coverage may want to carry a Medigap or Medicare Advantage Plan without a prescription drug plan.

Author Peter Hallberg  This email address is being protected from spambots. You need JavaScript enabled to view it.

EPPIA is a networking group whose members are committed to the welfare of seniors in our community. EPPIA meets five times a year to exchange information and problem solve in the field of aging. For more information on EPPIA please visit our website at www.edenprairieaging.org.