I had to laugh recently as a client said to me she wanted to review her Medicare insurance plan options before “Open Season” started. I sat there thinking, well, Medicare’s upcoming annual “Open Enrollment” is rather like hunting season and it does occur in Autumn each year… plus with all the mail Medicare beneficiaries receive, they may feel like they have a target on their backs. But of course they are NOT the same thing! LOL
However, there are some things you should know about the Medicare Annual Enrollment Period that applies to Medicare Advantage Plans and Prescription Drug Plans each year. This is the time of year that you can drop, add or change coverage. If you are happy with your current plan, you generally need do nothing – it automatically renews. Let’s review:
1.) You are still in the Medicare program, with all the rights & protections of Medicare. 2.) You still get complete Medicare Part A & B coverage through your Advantage plan. 3.) You can only join a plan during certain times of the year, and once you do join, you generally agree to keep the plan for the balance of the calendar year.
4.) You can join a Medicare Advantage plan even if you have a pre-existing medical condition, with the exception of End Stage Renal Disease.
5.) You can check with the plan in advance to see if a service is covered and what the cost will be.
6.) You must follow the plans rules, like getting a referral before seeing a specialist if your plan is an HMO (for most plans). If an HMO, you must use doctors from the plans network (unless medical emergency). PPO plans allow out-of-network coverage at higher costs.
7.) Advantage plans can’t charge more than Original Medicare for certain services like chemotherapy, dialysis and skilled nursing facilities.
8.) If the plan decides to stop participating in Medicare (with sufficient notice), you’ll have to join another plan, or go back to Original Medicare. 9.) Advantage plans have a yearly limit on your out-of-pocket expenses for your financial protection (unlike Original Medicare) and should you reach your limit, the plan will cover your medical expenses at 100%.
10.) Advantage Plans & Prescription Drug Plans can & do change each year, so current members please be sure to check the Annual Notice of Change mailed to you in September.
You can speak with a licensed agent beginning on October 1st about 2021 new plan benefits, and begin enrolling in a 2021 plan starting on October 15th, with a January 1st effective date. We are very excited to see this year will offer an affordable benefit for folks using insulin. Many plans will offer insulin coverage for $35 per month! So gather your medical information together, including a list of your medications and doctors you see. Now is the time to determine your best options for the upcoming year. Don’t be a sitting duck!
Call, click or come in today. We also offer no-touch virtual options for you.