Open Enrollment Is Here, Whats Next?

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How long has it been since you thought about your Medicare insurance? We are talking about the supplemental coverage you have through companies like Humana, United Health, or Blue Cross. If you have not done this in the past, now is a good time to start. Soon, your mailbox and TV screen will be filled with reminders about Medicare’s Open Enrollment period. Each year, Open Enrollment runs from October 15 to December 7. It is wise to think about the options you have before the window opens.

But why should you consider making a change to your current policies? The most common reason is that you have changed yourself. In fact, this is almost inevitable! You probably joined Medicare when you were a youngster, aged 65. Hopefully, you were in good health, needed little medical care outside of routine checkups, and had healthy lifestyle habits. But that may have been years ago, and now your situation has changed.

By the time you have reached age 75 or 80, you may need new medical specialists, different drugs, medical devices, or services like physical therapy. The plan that was adequate for a healthy 65-year-old senior is no longer filling the need. Medicare’s designers knew that this would happen, and they planned for it, knowing that every year some seniors would want to make changes. Open Enrollment offers a chance to make changing easy.
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Please note- It is possible to make changes outside of the Open Enrollment period, but only if you qualify for a SEP (Special Enrollment Period.) You will have to meet requirements like moving out of your old plan’s service area, losing your current coverage, or having a change in Medicaid status. This restriction makes it possible for insurance carriers to plan for a stable number of subscribers in the coming year.

What should you do before the Open Enrollment window starts? Take some time to think about your medical needs and “grade” your insurance plan’s performance. How well is that plan doing in meeting your needs? Doing this in a step-by-step manner will make it easier to choose the best option for yourself.

Start by making a list of all the providers you use. This includes physicians, labs, hospitals, pharmacies, and special services like physical therapy. Are all these doctors, drugs and other services covered by your current plan? If not, it may be time to think about a change.

Next, determine how much you have paid “out-of-pocket” for these services in the past year. “Out-of-pocket” expenses include deductibles, co-pays, out-of-network charges, etc. Many seniors are surprised by the cost of these “not covered” items in an insurance plan they thought was a bargain. Your current plan may seem like a bargain up front, but it turns out to be a costly mistake when all these extra costs are included.

A big type of uncovered services may be vision, hearing or dental expenses. Patients who started with Original Medicare and a Part D Prescription Drug plan probably have no vision or dental coverage. “Advantage plans” offer some vision and dental benefits. This added coverage may motivate you to
change to an Advantage plan. These plans often offer out-of-pocket savings compared to Original Medicare.

Keep in mind the types of changes you can make during Open Enrollment. You may change from Original Medicare to an Advantage plan, move from one Advantage plan to another, or change from an Advantage Plan to Original Medicare plus a Part D drug plan. If you make this choice, you will probably need a Medigap Supplemental plan. You can also switch between Part D plans.

Now is the time to think about this subject. Starting in early October, seniors will be bombarded with TV and mailbox advertising urging them to choose one plan or another. At best, these commercials are confusing. At worst, they can be misleading. They may use attractive phrases like “no additional premiums at all,” without mentioning limits on coverage or choice of providers. Seniors should be skeptical and investigate the details of each plan they consider. You can always reach out to Cynthia Batton from ASB Financial at 386-202-9304.

One source of dependable information is Medicare’s star rating system for Advantage plans. Each year, Medicare publishes a list of Advantage plans and rates their performance in meeting subscriber needs. These ratings will be published in early October, usually before Open Enrollment starts. will keep you up to date on these ratings and how you can use them.

Please keep coming back to OurSeniors.Net for the kind of information that helps you make the best choices. As your senior living magazine and online senior living magazine of choice, we will continue to inform you about topics like senior housing news, living in Florida, Social Security issues, and Medicare options.

Thanks for reading our blog and have a great day!