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Make Medicare Open Enrollment a Healthy Habit

Nov 15, 2016 03:33AM ● Published by Family Features

Routines help keep us focused, organized and healthy. However, if your health care routine doesn’t include preparing for Medicare’s Open Enrollment, now’s the time to kick-start a new healthy habit.

If you have a Medicare health or prescription drug plan, Open Enrollment runs Oct. 15 through Dec. 7. During this time, you can make changes to your plan which will take effect Jan. 1, 2017. Even if you’re happy with your current coverage, you might find something that’s a better fit for your budget or health needs. If you miss the Open Enrollment deadline, you’ll most likely have to wait a full year before you can make changes to your plan.

Here are five important things every Medicare beneficiary can do to get into the Medicare Open Enrollment routine each year:

1. Review your plan notice. Be sure to read any notices from your Medicare plan about changes for next year, especially your “Annual Notice of Change” letter. Look at your plan’s information to make sure your drugs are still covered and your doctors are still in network.

2. Think about what matters most to you. Medicare health and drug plans change each year and so can your health needs. Do you need a new primary care doctor? Does your network include the specialist you want for an upcoming surgery? Is your new medication covered by your current plan? Does another plan offer the same value at a lower cost? Take stock of your health status and determine if you need to make a change.

3. Find out if you qualify for help paying for your Medicare. Learn about programs in your state to help with the costs of Medicare premiums, your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, coinsurance and copayments, and Medicare prescription drug coverage costs. You can do this by visiting Medicare.gov or making an appointment with a local State Health Insurance Assistance Program (SHIP) counselor.

4. Shop for plans that meet your needs and fit your budget. Starting each October, you can use Medicare’s plan finder tool at Medicare.gov/find-a-plan to see what plans are offered in your area. A new plan may:

  • Cost less
  • Cover your drugs
  • Let you go to the providers you want, like your doctor or pharmacy

If you find your current coverage still meets your needs, then you’re done. Remember, during Medicare Open Enrollment, you can decide to stay in Original Medicare or join a Medicare Advantage Plan. If you’re already in a Medicare Advantage Plan, you can switch back to Original Medicare.

5. Check your plan’s Star Rating before you enroll. The Medicare Plan Finder is up-to-date with the Star Ratings for Medicare health and prescription drug plans. Plans are given an overall quality rating on a one to five star scale, with one star representing poor performance and five stars representing excellent performance. Star Ratings can be used to compare the quality of health and drug plans being offered.

For more information, call 1-800-MEDICARE (1-800-633-4227) and say “Agent.” TTY users should call 1-877-486-2048. Help is available 24 hours a day, including weekends. If you need help in a language other than English or Spanish, let the customer service representative know the language. You can also visit a local SHIP counselor, who can provide free, one-on-one, non-biased Medicare assistance. Find one at medicare.gov/contacts/. Additional information about Medicare is available on the Medicare Facebook page and by following @MedicareGov on Twitter.

Medicare 101: The Basics
If you are new to Medicare, here are some program basics:

Medicare is a health insurance program for:

  • people age 65 or older
  • people under age 65 with certain disabilities
  • people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant)

What are the different parts of Medicare?

Medicare Part A (Hospital Insurance):

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care

Medicare Part B (Medical Insurance):
Services from doctors and other health care providers

  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Many preventive services

Medicare Part C (Medicare Advantage):

  • Includes all benefits and services covered under Part A and Part B
  • Usually includes Medicare prescription drug coverage (Part D) as part of the plan
  • Run by Medicare-approved private insurance companies that follow rules set by Medicare
  • May include extra benefits and services for an extra cost

Medicare Part D (Medicare Prescription Drug Coverage):

  • Helps cover the cost of prescription drugs
  • Run by Medicare-approved private insurance companies that follow rules set by Medicare
  • May help lower your prescription drug costs and help protect against higher costs in the future

Photos courtesy of Getty Images

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