It’s that time of year again, Open Enrollment for Medicare and the Marketplace (ACA/Obamacare) which allows you to a chance to review your coverage.
Open enrollment for Medicare is the 15th of Oct to the 7th of Dec. During this time you can change your enrollment type, you can go from Original Medicare to a Medicare Advantage plan or from a Medicare Advantage plan back to Original Medicare or change Medicare Advantage plans. Medicare Advantage plans are plans that allows seniors to receive both Medicare Parts A and B benefits through a private health insurer that contracts with Medicare. Plans cover hospitalization, outpatient care, and, often, prescription-drug coverage under one plan. Many plans also kick in extra services that original Medicare doesn’t cover, such as dental and vision care. You need to do research on any plans to make sure that your doctors, the hospital that you want and other services are within the network that the plan covers. You will need to check out the total cost by adding up all possible costs, including monthly premiums, copays, coinsurance, and deductibles, so you’re clear about what your total spending could be for a given year. You can change your Part D plan during this time also. Most people change their Part D plan during this time. When comparing the plans also remember to compare restriction like prior authorization or a quantity limit, so you should look into those things to see what you need to do to access your drugs and networks if the plans have any. You can have different options to receive help with these changes. You can check with Medicare by phone at (800) 633-4227, on line at Medicare.gov, SHINE office at 1-866-531-8011, or an insurance agent. The WOCOA can also help. If you do use an insurance agent understand that if they are not independent agent, then they might be representing a certain plan or certain
If you are under 65 or not on Medicare, then your Open enrollment starts on the 1st of Nov and ends on the 15th of Dec.
You can apply for or renew your Marketplace coverage by visiting HealthCare.gov or by calling the Marketplace Call Center at 1-800-318-2596. The local Health Department also has a counselor to help with enrollments. When comparing plan under the Market plan it is the same as with Medicare: total health care costs not just the premium you pay to your insurance company every month. Other out-of-pocket costs, like coinsurance or a copayment, can have a big impact on your total health care spending, what benefits each
plan covers, and if the doctors, medical facilities, and
prescription drugs are covered by the plan
Remember you will get letters in the mail, calls from your plan, ads on TV, newspaper, free lunches/dinner to attend, etc to get you to sign up for a certain plan. You have options to help you review plans to ensure that what you have will work for you. Each plan is based on what medication you take, so what works for one will not work out for someone else. Compare and review during the Open Enrollment.