It is the time of year again to review your Medicare coverages. The Medicare Annual Open Enrollment Period will soon be upon us. Several weeks ago, we discussed Medicare Parts A, B, C & D. The Medicare Annual Open Enrollment Period has remained the same this year as the last several years, October 15, 2017 to December 7, 2017
During Medicare Open Enrollment, you have the option to move from traditional Medicare Parts A & B to a Medicare Part C Advantage plan or back, or change existing Medicare Part C Advantage plans and Medicare Part D prescription drug plans. If you recall from several weeks ago, Part C Medicare Advantage plans are private insurance plans that replace traditional Medicare Parts A & B. The Medicare Open Enrollment period overlaps with the Obamacare Health Insurance Marketplace Open Enrollment period of November 1, 2017 through December 15, 2017. However, according to www.medicare.gov, if you are on Medicare, you do not need to do anything with the Obamacare Health Insurance Marketplace during its or Medicare’s Annual Open Enrollment Period.
There is also another period called the Medicare Advantage Disenrollment Period from January 1, 2018 through February 14, 2018. During this period, if you are in a Medicare Part C Advantage plan, you can leave your plan and switch back to original Medicare Parts A & B. If your Medicare Part C Advantage plan included prescription drug coverage, you will also have until February 14, 2018 to join a Part D Medicare prescription drug plan to add drug coverage.
On February 15, 2018 and thereafter, Medicare institutes a lock-in period. During this time, generally no changes to Part D prescription drug coverage or Part C Advantage plans are allowed. As with most government programs there are a few exceptions to the rule when certain events happen in your life, such as if you move, lose other insurance coverage, are on Medicaid or live in an institution. These chances to make changes are called Special Enrollment Periods, which have special rules.
Before you decide what to do this year, you owe it to yourself to evaluate your options. So what’s the big deal? Why do you need to review your Medicare plan(s)? The reason is the insurance companies that sponsor the Medicare Parts C & D plans have the option to change what they offer each year and many of them do. Changes may come as a result of directives from Medicare, from previous years’ claims experience or from a multitude of other issues.
You should have received or will be receiving an Annual Notice of Change for any pending Medicare plan changes that are to be effective in January, 2018. You need to take the time to review the changes to be aware of the plans you are in and the benefits they provide when you might need to use the coverage.
This year is especially important for those of you considering Medicare Supplement (Medigap) plans. There currently is a plan to shut the door on Medigap C & F Plans. These are the most popular Medigap policies because, although they do not cover dental, vision or medicine, they cover the most medical expenses. The F Plan is more expensive since it covers 100% of all Parts A & B deductibles and co-pays, whereas the C Plan covers 100% of all Parts A & B deductibles and most co-pays. The federal government has announced that in 2020, C & F Plans will be closed to new enrollees. Under the current proposal, if you enrolled in a C or F Plan prior to 2020, you may continue it thereafter. But new enrollees in Medigap plans in 2020 on can only sign up for plans that make you pay Medicare deductibles and co-pays. You are going to have to make some difficult choices in the next couple of years.
If you are Medicare eligible and do not have a Part D, prescription drug plan you may want to consider enrolling in a Part D plan even if you do not currently take any prescriptions or ever had a drug plan before. If you do not sign up when you are first eligible and do not have other credible prescription drug coverage, you are subject to a monthly late enrollment penalty when you eventually do sign up.
Although the plan providers could only start marketing for their 2018 plans on October 1, 2017, you have probably seen earlier advertisements by providers getting a jump start by marketing their plans to “initial enrollees”. You will be getting a barrage of information. Be cautious when talking to Medicare “counselors” affiliated with an insurance company or other Medicare plan provider or booklets or other Medicare information provided by them. These are NOT unbiased Medicare counselors or information; these are sales and marketing tools attempting to get you to buy their plans. Rather than talking to someone from an insurance company, you are much better off speaking with an independent unbiased certified Michigan Medicare Medicaid Assistance Program (MMAP) counselor.
Medicare plan providers must follow certain rules when marketing their plans and getting your enrollment information. According to www.medicare.gov, people representing Medicare plans are not allowed to:
- Ask for your personal information (like your Medicare, Social Security, bank account, or credit card numbers) over the phone unless it’s needed to verify membership, determine enrollment eligibility, or process an enrollment request.
- Come to your home uninvited to sell or endorse any Medicare-related product.
- Call you unless you’re already a member of the plan. If you’re a member, the agent who helped you join can call you.
- Require you to speak to a sales agent to get information about the plan.
- Offer you cash (or gifts worth more than $15) to join their plan or give you free meals during a sales pitch for a Medicare health or drug plan.
- Enroll you into a plan, in general, over the phone unless you call them and ask to enroll.
- Ask you for payment over the phone or web. The plan must send you a bill.
- Tell you that they’re Medicare supplement insurance (Medigap) policies.
- Sell you a non-health related product, like an annuity or life insurance policy, during a sales pitch for a Medicare health or drug plan.
- Make an appointment to tell you about their plan unless you agree in writing or through a recorded phone discussion to the products being discussed. During the appointment, they can only try to sell you the products you agreed to hear about.
- Talk to you about their plan in areas where you get health care like an exam room, hospital patient room, or at a pharmacy counter.
- Market their plans or enroll you during an educational event like a health fair or conference.
If you think a plan or an insurance agent is not following the rules, call 800-MEDICARE (800-633-4227). TTY users should call 877-486-2048.
So how do you wade through all this data? Well the first thing you need to do is make a list. The list should include all your current prescriptions, the name and address of your pharmacy, the names and amount of monthly premiums of your Medicare Parts C & D plans and Medicare Supplement/Medigap policy, if any. Armed with the list, you then go online to the government website, www.medicare.gov or make an appointment with a certified MMAP counselor. When meeting with a MMAP counselor, always bring with you all of your current prescription bottles.
If you go online to www.medicare.gov, you will see that the website has changed little from last year. For Medicare Part C Advantage plans and Medicare Part D prescription plans, click on the large rectangular green button on the left side that says “Find health & drug plans”. For Medicare Supplement (Medigap) plans, hover over the blue button at the top that says “Supplements & Other Insurance” and click on the dropdown menu “Find a Medigap policy”. In addition, there are other buttons on the web page that will also get you there. You will be guided through a number of questions. When you are done with all the questions, it will list and compare Medicare Part C Advantage plans, Medicare Part D prescription plans and/or Medigap policies.
Be careful when you sign up for Medicare Part D prescription coverage so you do not unknowingly also sign up for a Medicare Part C Advantage plan. Many seniors have inadvertently signed up for a Medicare Part C Advantage plan when they thought they were only signing up for a Part D prescription drug plan.
You may not have a computer, the website may be overwhelming to you or you may not have someone else who can assist you. Two organizations in St. Clair County will have certified MMAP counselors to assist you this year, McLaren Port Huron and The Council on Aging, Inc.
McLaren Port Huron 55 Plus Senior Service Program is making MMAP counseling appointments to review Medicare Parts C Advantage plans, Part D prescription drug plans and Medicare supplement (Medigap) policies on October 17 & 25 and November 2. Call HealthAccess at 800-228-1484 to make an appointment. Bring in all your medications or a list of all medications and dosages to your appointment.
The folks at The Council on Aging in Port Huron are also assisting seniors again this year in evaluating and choosing standalone Medicare Part D prescription drug plans that are not part of a Part C Medicare Advantage plan. They are making appointments on October 17, November 1, 16 & 29 and December 6. They can be reached at 810-984-5061, extension 132. Bring in your Medicare card and all your medication bottles to your appointment.
With the tools that are available to you, you should be able to find the most appropriate coverages at the most economical prices to meet your health care needs.
By Matthew M. Wallace, CPA, JD
Published edited October 8, 2017 in The Times Herald newspaper Port Huron, Michigan as: Medicare annual enrollment starts Oct. 15