Question; I turned 65 earlier this year and signed up for Medicare for additional insurance, the Part D and other stuff. I see ads in the paper and am getting mail about plans, but I am all set for the new year, right?
Question; I turned 65 earlier this year and signed up for Medicare for additional insurance, the Part D and other stuff. I see ads in the paper and am getting mail about plans, but I am all set for the new year, right?
Answer: Well first, Welcome to Medicare! It sounds like you did everything right when you signed up for Medicare when turning 65. Once you have gotten beyond that Initial Enrollment Period, you begin to follow the Annual Time Line of Medicare.
This Timeline has an Annual Enrollment Period (AEP) that is October 15th to December 7th each year. So even though you recently made your insurance decision for your first year in Medicare, you now need to review that decision again.
This AEP does NOT REQUIRE you to change your insurance, but you certainly should re-evaluate your plan and the new coverage rules it is offering for 2020.
All of the plans announced their coverage on October 1st of each year. As of 10-1 you have an opportunity to review the insurance plan you have and how it has changed for 2020. You can evaluate your current plan and but also how it compares to the other 2020 plans!
You shouldn’t assume that your plan stays the same in 2020. If your plan changes so do all the other plans. I often compare this to automobiles. A Ford F-150 pick-up truck of 2018 is certainly different than the F-150 pick-up truck of 2020. Each year there are new features, options and benefit packages available.
Insurance is the same way. Each year the insurance products switch it up a bit and change their product to meet what they perceive to be the needs of the market. For the Stand-Alone Prescription Drug Plans (PDP’s). It may be a different premium (higher or lower), it may be a different Medication Tier system, it may be a different pharmacy network, it may be a different co-pay amount for your medications, or it may be a different formulary (medications the plans cover).
If you have a Medicare Advantage Plan (including your Hospitalization, Outpatient and Prescription Drugs, your plans will change as well. The premiums might be different, your co-pays for services may be different, and your drug coverage rules could change.
So this year you will get all kinds of mail again about the plans offered and why they think their plan is the perfect plan for you. You will see commercials on TV trying to convince you to change your insurance to that “better” plan.
I am not saying your current plan isn’t good; it may still be the best in 2020 for you. Your situation may be different this year. Maybe you are taking different medications now; maybe you are using a different pharmacy. But even if your personal situation is the same, your plan WILL be different! The difference may be subtle, but it should be evaluated.
Look at the material they sent to you on October 1st (maybe a little before that). Evaluate the premium, the co-pay structure for treatments and medications. Did the medication tiers change for your medications? Has it changed in a way that significantly impacts you?
Then consider using the www.medicare.gov website to evaluate all the plans available to you. If you don’t use the internet, try calling 1-800-medicare (633-4227). The Medicare customer support line is open 24 hrs. a day 7 days a week. Beginning October 1st you can call and begin to research the options.
If you want personal help with this decision, there are several agencies and programs to help you. Examples are Office for the Aging, Southwestern Independent Living Center and Senior Life Matters.
Don’t let this Annual Enrollment Period pass you by! October 15th to December 7th EACH year!
Once you have Medicare your birthday month is not a significant factor for your insurance coverage. You should still celebrate your special day, but don’t forget the Annual Enrollment Period of October 15 to December 7 each year. These are important dates in the future every single year!
So Happy Insurance Season! You must know this is my favorite time of year!
To contact Janell Sluga, GCMC with insurance questions or concerns, please call 716-720-9797 or e-mail at janells@lutheran-jamestown.org.
