Health Enroller’s Guide to Medicare’s Open Enrollment Part 3

Maybe you’ve heard the saying, “the grass isn’t always greener on the other side”? When it comes to Medicare plans, the grass might actually be brighter and greener on the other side! In fact, there’s proof. Studies show that on average, Medicare beneficiaries save $300 a year just by switching to the lowest cost Part D plan that covers all of their medications.

And it all starts with remembering to use the Medicare Open Enrollment Period to check out other plan options that might be available to you. 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.

To start, approach it like any other major purchase. For example, think about the steps you take when buying a car. You’re likely to test drive cars, compare features, review gas mileage, consider repair costs, and read reviews of the car. Shopping for a Medicare plan isn’t all that different. Learn more with our 5-step guide below:

1. Start with your Annual Notice of Change (ANOC) homework, outlined in our recent blog post, to compare your plan this year with its coverage in 2018. Then, compare it among many other options to see if the grass really is greener. In some states there are as few as 18 plans and others as many as 25 plans just to cover prescription drugs. Additionally, in some states there are as few as 1 Medicare Advantage plan and others as many as 30 plans. So, how can you know if there is better plan than what you have now?

2. Avoid the common mistake of choosing a plan based solely on the premium and deductible. You wouldn’t buy a car based on the monthly payment alone, so don’t do this with your Medicare plan either. Request your free personalized Medicare online marketplace from Health Enroller to shop and compare plans in your area.

3. Gather up your Medicare card and any bottles of prescriptions you currently take–your individual costs will vary based on the dosage of your medications and the frequency you take them. Once logged into your personalized Medicare marketplace from Health Enroller you can begin shopping for Medicare plans. You will be asked to input all of your medications and the pharmacy you use. This is very important in finding a plan that provides the best coverage at the lowest out of pocket cost based on your preferences. When you reach the plan summary page outlining all the plans available to you, look first at the “annual estimated cost” because it includes ALL out-of-pocket costs like the premium, deductible, and what you pay the pharmacy for your medication. You can compare multiple plans at a time so be sure to select your current plan and a couple of others to compare.

4. In addition to the cost, look at the “drug coverage information” section near the bottom of the screen. This is the section that details whether the plan will restrict access to the medications you need. The restrictions could include quantity limits on the number of pills per month, prior authorization from your provider, or step therapy (which requires you take another medication for up to 90 days before the insurance company considers paying for your usual medication). Restrictions aren’t necessarily a deal breaker, but you need to make sure you’re comfortable with them if they apply.

5. Using these shopping tips, narrow your choices down to two or three plans. Print out or write down the details of the plans and think about it for a few days. Make a list of any questions you have, and then call Health Enroller at 1-844-680-7855 to speak with one of our licensed benefits advisors. Health Enroller’s benefits advisors will answer all of your questions and assist you in making the best decision for you.

Remember, you have until Dec. 7th to make changes, but fall is a busy time–so don’t wait to the last minute and start shopping soon!

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