Health Enroller’s Guide to Medicare’s Open Enrollment Part 2

Welcome to Medicare Open Enrollment season! The Open Enrollment Period (OEP) occurs every year from October 15th to December 7th. During OEP, anyone with Medicare can change their prescription drug plan or Medicare Advantage plan for any reason.

Now that it’s October, your mailbox is probably overflowing with Medicare plan brochures trying to sell you every plan under the sun. While one of these new plans might be better than your current Medicare coverage, how do you know for sure? And, why go through the headache of researching new options if you like the plan that you have? Remember, Medicare plans can change what you have to pay each year as well as what they will pay for. To ensure that you still have the best plan for your needs, it is important to compare your plan to all the others plans available to you each year.

Switching to a different Medicare Advantage or Part D plan could potentially save you hundreds of dollars a year.

For starters, there are a few key steps you should take to take to find out if you’ve got the best coverage for 2018. The first step is to review what you have now, how much you pay for it, and what you think you might need next year. This begins with reading through your Annual Notice of Change (ANOC) packet, which your current plan should have mailed to you in late September. If you didn’t receive it, call the number on your Medicare card and ask for another, or go online and download a copy.

The ANOC is the thick packet most people place unopened in a drawer for “safekeeping”. Don’t be one of this people! This notice is crucial–it’s the only one required by law that details the changes in your plan from 2017 to 2018.

The ANOC lists any changes in your plan’s fixed costs, such as your monthly premium and deductible. However, don’t be fooled into keeping your current plan just because a quick glance shows that these costs haven’t increased. Go a step further and answer these critical questions too:

1. Are my current prescriptions still on the list of covered drugs, also known as the plan formulary? The ANOC does not detail these types of changes, so make sure you contact your plan or one of our agents at Health Enroller and find out if your drugs are still covered.

2. Are my drugs on a different tier now, with different cost sharing? Sometimes plans move drugs from a lower tier to a higher tier causing you to pay more for your prescriptions. If a generic form is available, talk with your doctor about taking the generic–it may lower your costs.

3. Do any of my drugs have new restrictions, such as needing approval from the plan before getting my medicine? Plans may add prior authorization requirements, quantity limits, and/or step therapy to medications from year-to-year. Plans often add these as safety measures when there are drug interaction concerns, or to verify a disease diagnosis. It is also a way for plans to control costs. Consider whether these new restrictions will work with your preferred prescription drug habits. If not, you may want to use this time to change your coverage instead.

4. Can I continue to use the same pharmacy? Are there changes to the cost of using your pharmacy? In recent years changes to pharmacy networks have been common. There are now at least three categories of pharmacies your plan may contract with as follows: preferred cost sharing (usually chains with lowest prices), network (mostly chains and lower prices), and out-of-network (may not even take your plan and most costly). If you can no longer use your preferred pharmacy, you may want to consider switching to a different plan.

Remember, you have from Oct. 15th to Dec.7 to make changes if you find a plan you like better for 2018. So gather your ANOC and other materials and start that research now!

For more information on how to evaluate your coverage options during Open Enrollment connect with one of our licensed agents for free professional advice about Medicare by calling 1-844-680-7855.

Leave a Reply

Your email address will not be published. Required fields are marked *