Your Guide to Medicare Open Enrollment: What to Know This Year
Medicare Open Enrollment occurs every year from October 15 through December 7 and is an important time for anyone enrolled in Medicare. During this period, you can review your current health coverage, make changes, or choose a new plan.
Why do I need to Review My Plan Every Year?
Medicare plans can change or adjust their coverage on a yearly basis. Insurance plans can make changes to premiums, deductibles, copays, provider networks, and covered medications. For example, a medication you need is no longer covered, or your primary care provider is no longer in network. Plans can also make changes to your extra benefits like dental and vision coverage. If you do not review your plan yearly, you could be surprised by higher costs and fewer benefits.
How do I review my plan yearly?
Every fall your insurance company will send you an “Annual Notice of Change” or “Evidence of Coverage”. This outlines any changes in coverage, drug formulary changes, premium increases/reductions, copays, and provider networks for next year. These notices should arrive in early September, so keep an eye on your mail or email. These notices will come directly from your Advantage (Part C) plans and your Drug (Part D) plan. If you do not get your notices before open enrollment, contact your insurance company for a copy.
The Social Security Administration also sends Cost of Living Adjustment (COLA) letters in late November/early December. These letters provide information on the increase in Part B premiums. This is important to review as it could adjust the amount of Social Security benefits you receive monthly.
How do I prepare for Open Enrollment?
Open enrollment can feel daunting and overwhelming; gathering some information prior to open enrollment can help make the process a little easier. Prior to open enrollment, you should gather the following information:
- Medicare cards and any other health insurance cards you may have.
- A list of current medications with doses.
- List of preferred doctors, hospitals, and pharmacies.
- Review your Medicare Summary Notices or Explanation of Benefits to see what services you used this year and may need next year.
- Annual Notice of Change or Evidence of Coverage
On October 15, you can use the Medicare Plan Finder tool on Medicare.gov. This site allows you to compare drug or advantage plans side by side. Medicare.gov allows you to compare estimated annual costs and drug coverage between plans. You can also add your doctors and pharmacies to see if they are in network. You can also enroll in a new plan for next year on medicare.gov.
How can I get help reviewing my plan?
If you feel uncertain about which plan to choose, the State Health Insurance Assistance Program (SHIP) can be a tremendous resource. SHIP offers free, confidential, and unbiased help to Medicare beneficiaries and their families. SeniorsPlus has a dedicated Medicare team that can provide education and assistance with reviewing coverage. Counselors with SeniorsPlus can answer questions you have about Medicare, assist in the comparison process, and explain your benefits. All SHIP counselors are trained and certified by the state of Maine.
SeniorsPlus can also help connect you to programs that can lower costs, such as Extra Help for prescription drugs or Medicare Savings Programs. SeniorsPlus provides free Medicare counseling for beneficiaries and caregivers.
Medicare open enrollment is an important time of the year. Open enrollment can help you make sure your healthcare meets your needs for the next year. By reviewing options, preparing your information, and using resources like Medicare.gov or SHIP counselors, you can feel more confident in choices for next year. Starting your planning now can help you make more informed decisions about your coverage for next year. If you would like to schedule an appointment with a SHIP counselor, reach out to SeniorsPlus or your local AAA.
Brandi Connor-Vargeson is the Medicare Supervisor at SeniorsPlus.
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