By Nicole Duritz
After 45 years as a pediatric nurse, my neighbor Sue enjoys her retirement. She has traveled with her husband, taken up yoga, and bonded deeply with her five grandkids. Since her retirement 3 years ago, she has been on Medicare. Earlier this year, Sue had a health scare. While she recovered well, Sue now takes new medications that her current Medicare prescription drug plan (Part D) doesn’t cover.
Lucky for Sue and for others with Medicare, she can always choose a different Medicare Prescription Drug plan during the annual Medicare Open Enrollment period.
Don’t confuse Medicare Open Enrollment with the new Health Insurance Marketplace that starts in 2014. The Marketplace is not for people who have Medicare. Instead Medicare has its own enrollment period.
The Window of Opportunity
Medicare Open Enrollment runs Oct. 15 through Dec. 7, 2013.
During this time, you can:
- Join a Medicare Prescription Drug plan;
- Switch from one Medicare Prescription Drug plan to another Medicare Prescription Drug plan;
- Change from a Medicare Advantage plan back to Original Medicare;
- Switch from one Medicare Advantage plan to another Medicare Advantage plan;
- Switch from a Medicare Advantage plan that doesn’t offer drug coverage to another Medicare Advantage plan that offers drug coverage;
- Switch from a Medicare Advantage plan that offers drug coverage to another Medicare Advantage plan that doesn’t offer drug coverage; or
- Switch from Original Medicare (Part A and Part B) to a Medicare Advantage plan.
Any changes you make will be in place on Jan. 1, 2014. If you miss the Dec. 7 deadline, you’ll have to wait until next fall to switch plans.
The 4 C’s
Whether it’s buying an airline ticket or picking your cell phone provider, it’s smart to compare your options so you can get the best value for your needs. The same goes for your health coverage. To help you make a good decision to either change your Medicare plan or stay with what you have, compare the four Cs: coverage, cost, convenience and customer service.
Start by comparing Medicare plans using the Plan Finder on the official Medicare website, or call 800-MEDICARE (800-633-4227). You can also work with a counselor at your State Health Insurance Assistance Program (SHIP). Ask the counselor questions about coverage issues you care about, like which drugs are covered, whether you will have coverage if you get sick while traveling out of state, and how much coverage you’ll have while you are in the Part D “doughnut hole” (the period during which you pay a higher share of your drug costs).
Consider what you pay today, and what the other plans offer and charge. When you compare costs, keep in mind that it’s more than just your monthly premiums. Look at the deductibles, drug costs and out-of-pocket maximums.
Look for a plan that provides you with easy access to your doctors and pharmacies. Also consider if the plan has online or mail-order prescription-filling options with the Medicare Plan Finder or call 800-MEDICARE (800-633-4227).
4. Customer Service
Find out how your plan ranks in customer service by comparing ratings. A plan can rate between 1-star (“poor”) and 5-stars (“excellent”). Medicare’s Plan Finder tool will show you the star-ratings when you click on the plan name.
Today as a result of the health care law, there are improvements to Medicare. For example, did you know that you no longer have to pay for Medicare-approved preventive care services? Also, if you fall into the Part D doughnut hole, there are discounts that lower your out-of-pocket costs.
These are just a few examples of how Medicare has improved.
Find more information on the health care law and protections and benefits to Medicare, or in Spanish. In addition, find more information about Medicare Open Enrollment and register for a free webinar.
And don’t forget to mark your calendar for Oct. 15-Dec. 7 to remind yourself to take advantage of Medicare Open Enrollment.
Nicole Duritz is Vice President of Health at AARP in the Education and Outreach group at AARP. She leads AARP’s consumer health education efforts. The focus areas include Medicare, the health law, prescription drug affordability, and long-term care, prevention and wellness. She can be reached at firstname.lastname@example.org .