Medicare Open Enrollment only comes once a year, and it's right around the corner. Here are five things you need to know to get the most out of this open enrollment season, which runs from Oct. 15 to Dec. 7, 2015.
- What is Medicare Open Enrollment?
Oct. 15 through Dec. 7, 2015 is the only time during which you can make changes to your Medicare Advantage (Part C) and prescription drug (Part D) plans. This means that if you don’t like your current plan, you can use this time to switch to another plan. Or, if you don’t currently have a plan, you can use this time to add one to your Medicare health coverage. - What are the different parts of Medicare?
Medicare is broken down into four main parts – Parts A, B, C and D.- Part A covers inpatient services like inpatient hospital care, skilled nursing facilities, hospice and other healthcare services.
- Part B covers outpatient services such as doctors' visits, outpatient hospital care, durable medical equipment (DME), preventative care and prescription drugs that require medical equipment to administer.
- Part C allows members to select a privately managed care plan to replace original Medicare and its benefits. Known as Medicare Advantage Plans, these plans provide all Part A & B services, but may do so with different rules, costs and restrictions.
- Part D is an optional outpatient prescription drug coverage that is provided through private insurance companies.
Again, only Parts C and D can be changed during Medicare Open Enrollment. For more information on each part, please see PHA's chart of Medicare benefits. - What should I know before changing my Part C plan?Medicare Advantage Plans must cover all of the services that Original Medicare covers, such as hospital care, medically necessary services, skilled nursing care, preventive services and durable medical equipment (DME). In addition, they may offer extra coverage like vision, hearing and dental.
Before you enroll in a new Medicare Advantage Plan, be sure to verify any and all information you receive. For example, if a representative says that a particular medical provider is in network, you should call the practice to confirm with the physician. - How do I choose a Part D plan?
Start by visiting PHA’s Part D Guide to help you outline the process.
If your Medicare Advantage Plan is an HMO or PPO, you should generally get drug coverage from that same company. If your Medicare Advantage Plan is a Medicare Savings Account (MSA), Private Fee-for-Service (PFFS) or Cost Plan, you can join a stand alone drug plan (PDP).
Using Medicare's plan comparison tool, investigate your prescription drug coverage and out-of-pocket costs. You will want to ensure that your plan covers all the medications you take and includes the pharmacies you prefer. - Additional ResourcesWatch Get Prepared for Medicare Open Enrollment, a PHA Classroom recording by Lauren Ruiz, Senior Case Manager at Caring Voice Coalition, for more information on Medicare Open Enrollment
Contact the Caring Voice Coalition (CVC) at www.CaringVoice.org or 1-888-267-1440 with questions. CVC's insurance specialists can help you navigate your current insurance coverage and help you identify and explore sources of new or improved coverage.
