Making Smart Medicare Choices for 2015

by Ron Pollack
Special to the NNPA from the Afro-American Newspaper

As we head into autumn, people with Medicare once again need to consider their options for next year. Even if you like the coverage you have now, you should spend at least a few minutes making sure it will still meet your needs next year. Here are some key questions that people with Medicare should ask.

When is the enrollment period?

Medicare’s open enrollment period runs, as usual, from October 15 to December 7. During this time, you can make changes in your Part D prescription drug plan or Medicare Advantage plan, or, if you don’t have one, you can select one for the first time.

How is this different from the open enrollment period for the health insurance marketplaces?

If you have Medicare, the health insurance marketplace is not for you. Medicare coverage and its open enrollment period are completely different from those of the health insurance marketplaces (which are also known as exchanges).

The health insurance marketplace offers coverage and financial assistance for people who do not qualify for Medicare–usually, people under age 65 who do not have permanent disabilities. The marketplace open enrollment period starts and ends later than Medicare’s. But if you have friends or loved ones who need coverage and do not qualify for Medicare, encourage them to check out http://www.healthcare.gov.

What are my options?

During Medicare open enrollment, if you have a Part D prescription drug plan or Medicare Advantage plan, you can change it. You can also join a Part D or Medicare Advantage plan for the first time.

If you currently have original Medicare and a supplemental plan (either a private Medigap plan or a plan with a former employer), be very careful before dropping your supplemental plan. You may not be able to get that plan back later.

How should I prepare for open enrollment?

If you have a Part D or Medicare Advantage plan, find out how your plan will be changing for 2015. Your current plan should mail you an Annual Notice of Change (ANOC) http://www.medicareinteractive.org/page2.php?topic=counselor&page=glossary#ANOC and/or an Evidence of Coverage (EOC) notice in September. These notices will highlight any changes in the plan’s costs, benefits, and rules for the upcoming year. Use these resources to find out whether your plan will cover the same services, drugs, doctors, hospitals, and pharmacies. Are premiums changing? What about copayments?

Once you know what your current plan will cover next year, you can start making comparisons. To compare your current plan to other plans, visit http://www.medicare.gov/find-a-plan.

If I like my current plan, do I need to do anything?

Even if you like your current Part D or Medicare Advantage plan, it could still be changing next year. You should always check to see what your plan will be covering next year and make sure it still fits your needs.

What if someone tells me I must buy a particular plan?

You should never believe any high-pressure sales pitch for a Medicare plan.

Private plans do sometimes decide to drop out of Medicare or change their coverage significantly. If this happens to your plan, take your time to learn about your options and make an informed choice.

You will never be left without coverage—you will always have the option of taking original Medicare.

How can I get more information?

You can get a lot of information about your options on the Medicare website, http://www.medicare.gov, or by calling 1-800-MEDICARE.

But the best way to get personalized help is to get individual counseling from your local State Health Insurance Assistance Program (SHIP). Every state has a program, and they offer free, unbiased advice. You can call 1-800-MEDICARE and ask for a referral, or go to http://www.Medicare.gov and click on “Find someone to talk to.”You can also visit https://shipnpr.shiptalk.org/shipprofile.aspx to find your local SHIP. SHIP offices get very busy during open enrollment, so try to call early to make an appointment.

What if I need financial help?

If you have limited income and resources, additional financial help is available. For more information, go to the Social Security website http://www.ssa.gov/prescriptionhelp, or call 1-800-MEDICARE and ask for a referral to your local SHIP.

Families USA is the national organization for health care consumers. We have advocated for universal, affordable, quality health care since 1982. Ron Pollack is the Executive Director of Families USA.