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Medicare Open Enrollment Means Time to Evaluate Your Current Coverage

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Closeup of a Medicare insurance enrollment form

Mark your calendar because Medicare open enrollment is coming very soon!

Medicare open enrollment, also called the Medicare Annual Election Period, is the one time each year when you can make changes to your coverage options, in the event that your health or the health of your loved ones has changed in the past year.

Each year, the Medicare open enrollment period begins on Tuesday, Oct. 15 and ends on Saturday, Dec, 7. Whether you have original Medicare, Medicare Advantage or a Medicare Part D prescription drug plan, now's the time to make any changes in your coverage. Changes in coverage made during this period go into effect on Jan. 1, 2014.

Medicare plan benefits and your needs can change on an annual basis, so using the open enrollment period to compare your options and get the right fit is the smart thing to do.

For example, during this past year, have you changed the medications you take? Been diagnosed with a new medical condition? Either of those two changes might mean that your current Medicare plan no longer meets your needs.

Medicare plans also change. The costs of your plan can go up or down, and prescription drugs can be added or dropped from the list of drugs (known as the “Formulary”) included in your plan. Some Medicare plans change the benefits offered or stop offering coverage in a particular location.

Because of such changes, you should check your current Medicare plan during open enrollment and, if necessary, switch to another plan that better meets your health-care needs

Have Medicare and not sure where to start? 

Begin by checking your current plan, and if necessary, make changes to get the health and drug coverage that best fits your needs. When reviewing plans, focus on the benefits, including coverage offered while you are in the prescription drug “doughnut hole,” the period during which you pay a higher share of your drug costs. Find out which drugs are covered using the Formulary for your plan.

You can compare the plans available in your area, and enroll in a new plan if you choose, by visiting Medicare.gov or by calling 800-MEDICARE (1-800-633-4227). This Medicare.gov health plan tool  allows you to compare plans and can help you find the one in your area that’s right for you. Another option for information and enrolling is to call the plan of your choice or visit the plan’s website.

After review, if you’re satisfied with your Medicare plan you don’t have to make any changes during the open enrollment period.

 

QUIZ: Think you know Medicare? Take our Medicare Open Enrollment Quiz

 

Close to one million Massachusetts residents (pdf) rely on Medicare, the federal health care program for residents age 65 and over as well as those with disabilities who may be younger. Last year, the Medicare program spent an estimated $9.9 billion on health care services for Massachusetts enrollees.

Medicare has several components

  • Original Medicare helps pay for hospital bills (Part A) and doctor bills (Part B). Because it does not cover all costs, many people also buy Medigap supplemental insurance, sold by private companies. (Medigap is not part of Medicare’s annual open enrollment.)
  • Medicare Advantage Plans (Part C) are an alternative to Original Medicare. They are private health plans, approved by Medicare, like HMOs or PPOs that feature co-payments for services, but also often operate with limited networks of doctors, specialists and hospitals.
  • Medicare Part D helps pay for prescription drugs. Plans are administered by private companies, approved by Medicare, and include: stand-alone plans that may be added to Original Medicare or Medicare Advantage, and plans that are part of Medicare Advantage.

 

Help for Massachusetts residents

Massachusetts residents who need help figuring out their Medicare options should contact SHINE (Serving the Health Information Needs of Elders), a free program that provides health insurance counseling. Visit the Massachusetts Executive Office of Elder Affairs for SHINE information, or check this SHINE telephone directory by city or town (pdf), or visit ageinfo.com, call toll-free 1-800-AGE-INFO (1-800-243-4636), or contact your local Council on Aging or Senior Center.

IMPORTANT DATES: 

  • Medicare open enrollment begins each year on Oct. 15 and ends on Dec. 7
  • Any changes you make to your Medicare selections will go into effect on Jan. 1, 2014

 

RELATED RESOURCES:

 

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