Medicare Open Enrollment Has Begun: What You Need To Know

Medicare beneficiaries have from Oct. 15 to Dec. 7 to decide on drug coverage and whether to switch from traditional Medicare or to a Medicare Advantage plan.


Medicare Coverage

Older or disabled Americans with coverage have noticed an uptick in mail solicitations from health insurance companies. This indicates that it’s time for the annual  open enrollment.

Most beneficiaries have from Oct. 15 through Dec. 7 to decide which private plans offer the best drug coverage for 2018. Or whether it’s better to leave traditional coverage and get the combo policy called Medicare Advantage.

Some tips for the novice and reminders for those who have been here before can make the process a little easier.


Pay Attention To The Mail

If you are already enrolled in the Advantage plan, carefully read the “annual notice of change” or “evidence of benefits” letter from the insurer. It is not another sales pitch or more insurance mumbo-jumbo. That required letter highlights the cost and benefit changes in store for next year. Ask the insurer for another copy if you can’t find it.


Choose Between Traditional or Medicare Advantage

The open enrollment period is your opportunity to switch plans, including moving between the government-run traditional program and Medicare Advantage.

Medicare Advantage plans are offered by private insurers, which receive payments from the federal government to help cover the costs of beneficiaries. They restrict members to their network of doctors and hospitals and a list or formulary of covered drugs. With some rare exceptions, you cannot leave the plan mid year, even if the plan drops drugs from your hospitals, physicians, or medical equipment suppliers.

But unlike traditional, Medicare Advantage plans often cover dental, hearing and vision care, and they cap your out-of-pocket expenses. Once you reach that limit, the insurer pays for covered services, and you pay nothing. But details of these plans, such as the caps on member spending, the premium prices and service areas, can change from year to year.

On the other hand, with traditional Medicare, patients can go to any provider who participates in the program, and most providers do. Because there is no limit on the share of medical expenses beneficiaries pay, most purchase “Medigap” supplemental policies or have other insurance to lower those costs.


Check The Calendar

There’s a lot to consider and only seven weeks to do it. And remember, this enrollment period is different from the Affordable Care Act’s marketplace enrollment, which begins Nov. 1 and lasts through Dec. 15.

Federal officials have granted seniors who live in areas affected by this year’s hurricane damage — Alabama, Florida, Georgia, Louisiana, Mississippi, South Carolina, Texas, Puerto Rico and the U.S. Virgin Islands — or depend on caregivers in those areas until the end of December to make their choices.


Getting Help

Individual assistance is free from the federally funded Senior Health Insurance Information Program, the Medicare Rights Center (800-333-4114 and its website Medicare Interactive as well as from Medicare’s plan finder website and helpline (800-633-4227).

Studies have shown that most Medicare beneficiaries don’t switch plans.

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