Medicare Open Enrollment
When it comes to government programs designed to help those who are retirement age, frequently Social Security reigns supreme. However, Medicare should be placed right beside Social Security in importance. Medicare is an excellent benefit to the aging American public and a great safety net for that age group. At the same time, without proper guidance, Medicare can also be a source of great frustration.
The annual Medicare Open Enrollment period is October 15th through December 7th. During open enrollment, people have the opportunity to make changes to their Medicare Part C or Part D plans. They can reaffirm their prior year’s decision and remain under that same current program. But they can also make a change into a new different Medicare Advantage plan or a different Part D plan.
What Can I Do During Medicare Open Enrollment?
Both of the plans mentioned above are eligible to be changed during this time, but they are unrelated. Part D prescription drug coverage is a prescription drug insurance plan through a federal program. Outside of a few exceptions, Medicare and Medicare supplement plans do not cover prescription drugs. So, these federal programs help pay for prescriptions. These plans become prescription component for those covered for their health care through a supplement carrier. These are frequently known as Medigap or tie-in-plans. If you’re on a Medicare advantage carrier that doesn’t include prescriptions, Part D can be purchased to help pay for the medicines.
Medicare Advantage & Part D Plans
The far more common Medicare advantage plans found in this market area include prescription drug coverage. The other coverage subject to changes during the annual Medicare Open Enrollment is the Medicare Advantage plan that provides for prescriptions. The reason for the Medicare Open Enrollment period every year is to accommodate any health care changes, including the use of prescriptions, that may need updating during the last 12 months.
Other than improvements in coverage from a Medicare Advantage carrier, like dental and vision, the Medicare Advantage plan may have made changes in prescription coverage.
It’s important to note that Medicare Advantage plans and Medicare Part D plans are not required to offer all prescriptions but still must provide a minimum standard level of drugs as set forth by Medicare. Plans can vary the list of prescriptions they cover, known as their formularies, and how they place drugs into different tiers on their formulary. Being that Medicare advantage plans, (as well as Medicare Part D carriers) update their formulas each year, it’s prudent for everyone who will or does participate in Medicare to review plans annually. A better choice may be available based on their current prescription drug usage.
We encourage all Medicare participants to review their current plan during this time of year to see if a different carrier will be a better fit for the following year. The Medicare website, Medicare.gov, allows a person to load their current list of prescriptions to learn which plans best fit your prescription needs based on drug coverage and into which tiers the drugs fall. The annual Medicare Open Enrollment also exists to provide an opportunity to change from a current Medicare Advantage carrier, or their current Medicare Part D prescription plan, into another plan that may better fit their changing prescription needs.
Medicare Supplement, Tie-in, or Medigap Plans
Medicare supplement plans, also known as Medigap or tie-in-plans, are not part of this annual Medicare Open Enrollment. The commercials on television and in print-ads that flood our mailboxes encourage people to conclude that they can change supplement carriers during this time. That’s simply incorrect. Supplement carriers require underwriting to learn if a person is insurable under their conditions and requirements. The only exception to the underwriting requirement is that there is a six-month time period if you are both age 65 and enrolled in Medicare Part B. If that is the case, you have a guaranteed issue right. During those six months, annual Medicare Open Enrollment does not change this or apply to supplement plans.
Planning for retirement is complicated, at best, but once you throw Medicare on top of it, it can be baffling. If you aren’t careful, mistakes can be costly. Retirement is not an ideal time for large out-of-pocket medical bills and high premiums. Additionally, neglecting important deadlines may cause coverage gaps, penalties, and possibly disqualify yourself for certain tax breaks. If you have any questions about your Medicare situation or the annual Medicare Open Enrollment period, fill out the form below or give us a call at 913-393-1000.
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