By Dave Reville
For anyone with Medicare, the fall season means more than watching our favorite football team and enjoying the foliage. Oct. 15 through Dec. 7 is also Medicare open enrollment season.
Medicare open enrollment is the only time of the year when the 92,000 Vermonters who have Medicare can review and make changes to their Medicare coverage. Any changes you make will be in place on Jan. 1, 2013.
During open enrollment you can:
- switch to a Medicare Advantage plan
- switch from one Medicare Advantage plan to another
- drop your Medicare Advantage plan and return to Original Medicare
- join a Medicare Prescription Drug plan, change to a new one or drop your coverage.
It is always a good idea to review your plan to make sure you are getting the most out of your Medicare coverage. Evaluating your plan options is easier than you think. Just follow the four “Cs”—coverage, cost, convenience and customer satisfaction.
Comparing Medicare plans is simple. The official Medicare website has a tool at www.Medicare.gov/find-a-plan that helps you find and compare all of the plans available in your area. When reviewing plans, focus on the benefits, such as the coverage offered while you are in the “doughnut hole,” the period during which you pay a higher share of your drug costs. Find out which drugs are covered.
If you need help comparing coverage options, you can work with counselors at Vermont State Health Insurance Assistance Program, which can be reached at 1-800-642-5119. Be sure to ask the counselor questions about issues that matter to you, such as whether you will have coverage if you get sick while traveling out of state.
From year to year, your Medicare plan costs may change. During open enrollment, you should compare all of the costs, including premiums, deductibles, drug costs and out-of-pocket maximums.
When it comes to going to doctor’s appointments and filling prescriptions, convenience matters. When comparing Medicare plans, find out if you will have access to nearby doctors. Use the Medicare Plan Finder (www.medicare.gov/find-a-plan/) to locate plans that your local pharmacy accepts or plans that provide online prescription-filling or mail-order options.
Have you ever wondered how your Medicare plan stacks up against the rest? When you’re comparing plans, use Medicare’s star-rating system. Medicare health and prescription drug plans are rated on how they perform in different categories, such as responsiveness and care, member complaints and customer service. A plan can rate between one star (“poor”) and five stars (“excellent”). You can view the star-ratings at www.medicare.gov/find-a-plan by clicking on the plan name. You can compare up to three plans at once.
After the Four Cs, You are Ready for D (Decide)
Remember, even if you are happy with your Medicare plan, it is wise to evaluate your options, since the open enrollment period is the one time each year you can switch plans. Once you go through the four Cs of comparing coverage, cost, convenience and customer service, you can make a well-researched decision to either change your plan or stay with what you have.
Remember, it is important to review your options carefully. In some cases, if you drop your coverage you might not be able to get it back.
Of course, you may decide to keep the coverage you have. But, if you miss the Dec. 7 deadline, you’ll have to wait until next fall to switch to a different Medicare plan.
For more information about Medicare open enrollment, visit www.aarp.org/openenrollment.
Dave Reville is the associate state director of AARP Vermont.