It is that time again – the time to remind anyone who wants to review or change their Medicare coverage that Medicare Open Enrollment is almost here. If you are on a Medicare Advantage Plan or if you are on a Medicare Supplement but have prescription drug coverage under Medicare D, Medicare Open Enrollment is the time when decisions are made regarding certain Medicare plans for the next year. Open enrollment for 2021 will begin on October 15 and will continue until December 7, 2020.
Soon you will like receive many glossy flyers that, honestly, often do not help in decision making.
Here is what you need to know.
First, of course, the choice of insurance plans is complicated. Second, decisions will not always be based on the cost of monthly premiums. You need to also consider the cost of prescription drugs you are using and on what tier they are placed or whether they are considered specialty drugs. Generally speaking, if you have a Medicare Supplement plan it has certain advantages over a Medicare Advantage plan especially if you might move or become seriously ill.
Open enrollment is primarily to determine whether you want to change from one Medicare Advantage plan to another Medicare Advantage plan. You can also change from one Medicare D (prescription drug plan) to another.
One exception, if you are just turning 65, you can sign up as soon as you become eligible, not just in October until December, and can choose whether you want a Medicare Supplement or a Medicare Advantage plan. This is a window of time.
Later, if you already have a Medicare Advantage plan and want to change to a Medicare Supplement, you may need to pass medical underwriting to qualify for the Medicare Supplement.
Sometimes individuals sign up for Medicare Advantage plans recognizing the premiums are often lower. When the same individual becomes seriously ill, he or she may discover that their Medicare Advantage plan is limited or is not accepted by certain doctors or hospitals. Medicare Advantage plans are limited to a given geographical area. So, if you have a plan in Pennsylvania and move to Ohio, for instance, you may need to apply for a different plan. Medicare Supplement insurance is accepted by any doctor or hospital that accepts Medicare.
If you are confused, get help. The Chester County APPRISE program staffed by volunteers, is excellent. It can be contacted at 610-344-6035.
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.