By Ross Blair, CEO of PlanPrescriber October 3, 2012
The annual enrollment period for next year’s Medicare Advantage and
prescription drug plans is just around the corner. Whether you’re
approaching age 65 or already enrolled in Medicare, you should take
advantage of this once-a-year opportunity to review coverage options and see
whether you are enrolled in the most cost-effective plan for your needs.
Research by PlanPrescriber.com shows that a large majority of Medicare could
have saved hundreds of dollars last year by reviewing just one element of
their coverage: their prescription drug plan. While it may be easy to come
up with other things you’d rather do this fall, taking time now to review
all of your coverage options could really pay off.
Like last year, the annual enrollment period is coming a month earlier than
usual, running from Oct. 15 to Dec. 7. Though Medicare beneficiaries have
eight weeks to select their coverage, last year 42 percent of people waited
until the last nine days to apply, according to research by
PlanPrescriber.com. However, this is not a decision you want to rush or put
off until the last minute. Last year, federal officials extended the Dec. 7
deadline by three days for certain people because of an influx of
last-minute sign-ups. You can avoid the rush this year by starting to
compare plans on Oct. 1, which will prepare you to enroll Oct. 15.
We’ve compiled some important tips for people on Medicare to help ensure
they pick the best Medicare Advantage or prescription drug coverage for
their specific needs.
Understand the basics before filling in the gaps. Understanding Medicare can
be challenging, but it’s important to understand what Original Medicare
(Parts A and B) cover before weighing other options. Once you understand the
basics, you can compare products designed specifically to fill some of the
different gaps in Medicare. These products include Medicare Part D
stand-alone prescription drug plans, which cover the cost of most
prescription drugs; Medicare supplement plans, which cover portions of the
deductibles, coinsurance and out-of-pocket costs not covered by original
Medicare; and Medicare Advantage plans, which bundle together the Part D
drug benefit with some additional coverage for deductibles, coinsurance and
out-of-pocket costs. Each type of supplemental coverage has different
guidelines for when you can enroll, change and cancel your coverage.
Prescription drug plans can change every year, so check the benefits for
2013. If you get coverage through a Medicare Advantage or prescription drug
plan, know that most plans change their pricing and benefits each year. You
can use an online tool to see whether and how your prescriptions drugs will
be covered in 2013. According to a study by PlanPrescriber.com, the average
person could have saved $654 in 2012 by changing their coverage to a plan
that covered their drugs at the lowest possible cost.
Factor in costs like copays and deductibles. At first glance, it may appear
best to go with the plan with the lowest premium. However, you are still
responsible for out-of-pocket costs. Also consider such costs as doctor’s
office copayments and deductibles. Those expenses can add up, meaning the
plan with the lowest premium could cost you more in the long run.
If you’re turning 65 during the enrollment period, happy birthday and know
the deadlines. Hundreds of thousands of people will turn 65 during this
year’s annual enrollment period. If you’re already getting Social Security
benefits, you will be contacted a few months before you become eligible for
Medicare and given the information you need. Most people are enrolled in
Medicare Parts A and B (Original Medicare) automatically.
While you’re celebrating, keep in mind that other types of coverage have
different deadlines that are important to remember:
• Part D prescription drug plans. You must enroll during the annual
• Medicare Advantage. You have three months to sign up after you
enroll in Medicare Part A and Part B benefits. Otherwise, you’ll have to
wait for next year’s annual enrollment period.
• Medicare Supplement insurance (Medigap). The Medicare Supplement
Open Enrollment Period is six months, beginning the first day of the month
in which you are both age 65 (or older) and enrolled in Medicare Part B. If
you miss the Medicare Supplement Open Enrollment Period, your application
could be declined if you have a pre-existing medical condition or you may be
charged more for coverage.
Finally, remember that there’s no reason to enroll without help. Qualified
professionals can help you understand your options and select a plan. You
can get help through your State Health Insurance Assistance Program (SHIP),
websites like www.PlanPrescriber.com, licensed health insurance agents who
are certified to sell Medicare, or by calling 1-800-Medicare.
Ross Blair is President and CEO of PlanPrescriber, Inc.
(www.PlanPrescriber.com <http://www.PlanPrescriber.com>), a leading provider
of comparison tools and educational materials for Medicare-related insurance
The Centers for Medicare and Medicaid Services (CMS) has neither reviewed
nor endorsed the information provided by PlanPrescriber.