Here’s the good news about Medicare open enrollment: the new healthcare laws don’t affect how you shop for coverage, and you don’t have to go to a new health exchange site to compare plans.
“They are two separate things. If you are on Medicare, there is no reason to go on the Health Exchange, because there is nothing for you there,” said Anne Chansler of the Florida Department of Elder Affairs. The Health Exchange is for people who are under 65 and uninsured, she said.
Medicare open enrollment, which began Oct. 15 and ends Dec. 7, allows Medicare beneficiaries to review and compare coverage, and change to a new plan if they wish.
“If you were in a plan that fit you well last year, but this year you have new prescriptions, new medical needs, new doctors — that plan may not be the best fit for you anymore,” said Chansler, who is state director of SHINE, Serving Health Insurance Needs of Elders, a federally-funded, volunteer-based program to help Medicare beneficiaries understand and compare coverage. “That’s why we encourage people to look at the options available every year, because they may have something in the system that’s better or more affordable.”
During open enrollment, Medicare beneficiaries can 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.
Even if you want to stick with the same plan, it’s important to examine your coverage every year.
“You should go through the exercise and recheck costs and what your plan covers,” said Kathy Sarmiento, a Miami-Dade SHINE liaison who works out of the Alliance on Aging office in Miami. “Drug costs can change, and what a plan covers can change.”
A copy of “Medicare and You 2014,” 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. You can also call 800-MEDICARE for help.
Since the Affordable Care Act was passed in 2010, Medicare Advantage premiums have fallen by 9.8 percent, according to the Centers for Medicare & Medicaid Services. In 2014, the average Medicare Advantage monthly premium is projected to be $32.60. The Medicare prescription drug premium plan is projected to be $31 per month, holding steady since 2010. The deductible for standard Part D plans will decrease by $15 to $310.
Drug coverage in the Part D “donut hole,” the temporary gap in prescription coverage that begins after you and your drug plan have spent a certain amount for covered drugs, will increase until 2020, when the donut hole will be closed. Those who reach the donut hole will enjoy a little more savings in 2014 on generic prescription drug costs. Coverage has increased from 21 to 28 percent for generic drugs. Coverage will remain at 52.5 percent for name brand drugs.
Free help to examine Medicare options is available from SHINE volunteers, who help clients compare policies and understand health insurance coverage.
“They can also screen you to see if your income and assets qualify you for programs that will help pay your co-payments, premiums and drug costs,” Sarmiento said.