You can’t tell it by looking at the calendar, unless you know what you are looking for, but we are getting ready to head into one of the most important times of the year. No, I’m not talking about the holiday season, although I’m sure we will be hearing Christmas songs sometime soon. It’s a particularly important time of year if you or a loved one are covered by Medicare. It’s the Medicare open enrollment period, the time when Medicare beneficiaries can make changes to their plan and pick one that works best for them. In effect, each year you get a “do-over” on choosing your plan. The open enrollment period starts on October 15 and ends on December 7.
Medicare Open Enrollment Period
Open enrollment is a big deal, but unfortunately, most people don’t take advantage of it. Make sure you don't let December 7 slip by without at least reviewing your Medicare options. Don’t assume the plan that was best for you in 2017 will be the best for you in 2018. Plans change every year, and the open enrollment period is your chance to trade in your old plan for one that fits you better. (For more for this author, see: Medicare Enrollment Part 2: The Right Path for You.)
Are you satisfied with your current Medicare plan? Has it changed? Have premiums or out-of-pocket costs gone up? Has your health changed? Do you anticipate any change in medical care or treatment? Is the drug coverage you have still appropriate? These are all important questions to ask yourself because during open enrollment, you can switch from original Medicare to a Medicare Advantage plan, or from a Medicare Advantage plan to original Medicare; you can change from one Medicare Advantage plan to another; you can enroll in a Medicare Prescription Drug Plan (Part D) or switch from one Part D plan to another.
Changes to Your Medicare Coverage
Speaking of prescription drug coverage, one of the big changes that occurs every year is a plan’s formulary, the plan’s list of medicines that are covered and how they are covered. Drug makers can raise or lower their prices, which will have an effect on your plan. Maybe a cheaper, generic version of a drug you need has become available. A plan’s formulary is one of the things you must review when evaluating Part D coverages. What good is a plan if it doesn’t cover the drugs you need?
So, where do you start? First, you should receive a notice from your current plan about any changes that will occur in 2018. They are required to send the notice to you for review. And while it’s a bit of a long document, it’s not difficult to work through if you know what you are looking for. Here are some of the things you should be reviewing:
- Monthly premiums – any change from last year
- Deductibles – they generally change a bit each year, and some plans will absorb some of the cost increases
- Co-pays – coinsurance and any changes in amounts or requirements
- Drug tiers – to see if any drugs you take are moving from one pricing tier to another
- Out-of-pocket-maximums – you may have two caps to review, one for health coverage and one for drug coverage
- Provider networks – to see if your doctor and hospital choices have changed
- Drug formularies – for the reasons mentioned above
Open Enrollment Resources
Open enrollment is also important because it gives you, as a consumer, a big say in what plans are offered. The best plans available are rewarded with new business as consumers exercise their right to choose. The plans that consumers don’t like will have to either change or disappear. But while open enrollment is good in theory, most people typically stay with what they have, even despite evidence that they would be much better off by changing to another plan.
Don’t be most people. By spending a few hours each year reviewing the changes in your plan, and the other plans that are out there, you can become a savvy Medicare shopper. Many articles have been written about what health care costs will be in your retirement years. Here is one way that you can work to control those costs.
(For more from this author, see: Medicare Enrollment Part 1: When to Enroll.)