Everyone with Medicare who is enrolled in a private health or drug plan should review their choices during the Fall Open Enrollment Period, the Medicare Rights Center, a consumer service organization, recommends.
Even people who are currently satisfied with their plan should examine it, because plans change benefit packages every year. Those enrolled in Original Medicare can also decide at this time to switch to a private plan.
The Fall Open Enrollment Period runs from Oct. 15 through Dec. 7. During this time, Medicare beneficiaries can make changes to their health and drug coverage options without restriction. They have the right to make as many changes as they need, and the last change they make by December 7 will go into effect on Jan. 1.
“Medicare beneficiaries need to be aware of any changes to their current plan and carefully review all of their options in time to make a decision by Dec. 7,” said Joe Baker, president of the Medicare Rights Center. “While reviewing your options, it is important that you contact the plan to confirm any information you find. Once you have made your decision, you can enroll in the plan by calling 800-MEDICARE.”
Everyone with a Medicare Advantage plan, also known as a Medicare private health plan, or Medicare drug plan should have received their Annual Notice of Change by Sept. 30. The notice lists the changes in the plan, such as the premium and copays, and compares the benefits in 2014 with those in 2013.
Medicare health coverage
The Medicare Rights Center urges people to consider the following questions before enrolling in a Medicare Advantage plan:
- Will I be able to use my doctors? Are they in the plan’s network and are they taking new patients who have this plan?
- Have my doctors’ experiences with this plan been positive? What problems have my doctors seen with patients in this plan?
- Which specialists, hospitals, home health agencies, and skilled nursing facilities are in the plan’s network?
- Who can I choose as my primary care physician?
- How much is my monthly premium?
- How much will it cost to see my primary care physician? A specialist?
- Do I need a referral to see a specialist?
- Are my prescription drugs on the plan’s list of covered drugs?
- Does the plan require that I get “prior authorization” before my prescription will be covered, or impose other restrictions, such as limiting the quantity or requiring that I try a cheaper medication before it will cover a more expensive one?
- How much will I have to pay out of pocket before coverage starts?
- How much will I pay for brand-name drugs? How much for generic drugs?
- What service area does the plan cover?
- What kind of coverage do I have if I travel outside of the service area?
Use the Medicare Plan Finder tool at www.medicare.gov or call 800-MEDICARE to review your options and get details.