When Rose Rush, 67, of Miami started taking new medicine for diabetes, she promptly saw her prescription costs rise. Now Rush, who is on Medicare, is evaluating plans to see if she can lower her drug costs by choosing another provider.
As Medicare’s open enrollment got underway this week, millions of Medicare beneficiaries are being urged to do the same.
“Each year plans can change what they cost and what they cover. A person’s health needs can also change from year to year,” said Isabella Leung, spokeswoman for the Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services. “People with Medicare should take advantage of open enrollment to look at how changing costs, benefits and quality could affect them.”
The annual open enrollment period, which ends Dec. 7, allows Medicare beneficiaries to move from Original Medicare (known as Parts A and B) to a Medicare Advantage Plan (Part C) or vice versa. They also can elect to change their prescription drug coverage (Part D). Changes will take effect Jan. 1.
This year, some providers have consolidated plans with identical coverage, which means about 1,400 Broward and 300 Miami-Dade residents will receive notices renewing them to a different plan within the same company.
“Plans were consolidated with the purpose of making plan choices simpler for the consumer,” said Andrea Gary, spokeswoman for the state Department of Elder Affairs. Consumers should examine the benefits of the new plan, she said, to make sure it meets their needs.
Even if you’re sticking with the same plan, it’s important to examine your coverage every year, Gary said. “It may have the same name, but it could change formularies or benefits. They can change from year to year, so it may not offer the eye benefits or gym memberships it did in prior years,” she said. “If people are not reviewing the information, you may get enrolled in a plan you don’t want.”
Rush had always favored retail pharmacies for drugs, but now she’s looking at mail-order pharmacies to lower costs. And she’s evaluating Medicare providers to see which best meets her needs.
“Medicare has great online tools where you can look at price comparisons of deductible and co-insurance, but the bottom line is annual cost. I go to that first,” she said.
The Medicare.gov website also alerts you if a generic is available for a name brand drug you are taking, so that you can discuss it with your doctor, she said. Rush, a consultant for the Alliance on Aging in Miami, and a former volunteer for SHINE, Serving Health Insurance Needs of Elders, a federally-funded, volunteer-based program, is used to advising seniors to compare options. Now she’s taking her own advice.
“People are very overwhelmed by choices during open enrollment. They get tons of mail from all these companies,” Rush said. “It’s best to compare plans side by side.”
A copy of “Medicare and You 2013,” which explains deadlines and benefits, has been mailed to every Medicare beneficiary. A digital copy at Medicare.gov can be read online or downloaded to an eReader like a Kindle or Nook.
Enrollment in Medicare Advantage Plans is projected to rise by 11 percent in the next year, according to the U.S. Department of Health and Human Services. Since the Affordable Care Act was passed in 2010, Medicare Advantage premiums have fallen by 10 percent and enrollment has risen by 28 percent.