Senior Life Matters

9/10/18: I turned 65 and signed up for Medicare. What next?

Question: I turned 65 earlier this year (2018) and signed up for Medicare. I also signed up for additional insurance, the Part D stuff. I am getting mail about plans, but I have until my birthday to change my insurance right? Can I ignore what is happening now?

Answer: How do you like Medicare? It sounds like you did everything right when you signed up for Medicare when turning 65. When you turn 65 there are timeline issues that are unique to you because of when your birthday falls. After that, your timeline becomes the time line of Medicare as it changes year to year.

Once you have Medicare and are enrolled in a plan of your choice you must abide by the Annual Medicare Timeline. This Timeline has an Annual Enrollment Period (AEP) that is October 15th to December 7th each year. I noticed that in the material from Center for Medicare & Medicaid Services (CMS) they are calling it the ‘Fall Open Enrollment’. As you stated, you recently made your insurance decision for your first year in Medicare, you NOW need to review that decision again for next year (2019).

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 2019.

All of the plans announce 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 2019. You can evaluate your current plan and also how it compares to the other 2019 plans! You shouldn’t assume that your plan stays the same in 2019. If your plan changes, so do all the other plans.

I often compare this to automobiles. A Ford F-150 pick-up truck of 2013 is certainly different than the F-150 pick-up truck of 2019. 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. 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 are enrolled in a Medicare Advantage Plan (which includes Hospitalization, Medical & Prescriptions), the medical co-pays, deductibles and coverage will change in some way for 2019.

So this fall 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 be the best in 2019, like it was in 2018.

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 send to you by October 1st. Evaluate the premium, the co-pay structure and the medication tiers. Then consider using the 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! This period of time is when you can make the change, if you decide to change your plan.

Once you have Medicare your birthday month is not a significant insurance factor for you. You should still celebrate your special day, but don’t forget the Annual Enrollment Period of 10-15 to 12-7 each year. These are important dates also!

So here is to a Happy Insurance Season to all! You now know why 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