Another Medicare Open Enrollment period has arrived. This is the time each year when Medicare beneficiaries are able to explore their options regarding Part D prescription drug plans and Part C Medicare Advantage (MA) plans. The Open Enrollment period runs from October 15, 2013 until December 7, 2013. Plan changes take effect on January 1, 2014.
During open enrollment, Medicare beneficiaries can enroll in a Part D drug plan for the first time or change plans. Beneficiaries can also enroll in an MA plan, change their MA plan, or move to original Medicare from a MA plan. (If you are considering moving to or from traditional Medicare, see my blog post Choosing Between Original Medicare and Medicare Advantage).
Use the Medicare Plan Finder
The best way to find and compare your options for Medicare Part D or Medicare Advantage plan (Part C) coverage is to visit the Medicare plan finder online. Click here to access this tool: http://tinyurl.com/n5dusf6. Plan information for the upcoming year is now available on the Medicare plan finder.
Once on the website you can find and compare the plans that are available in your region. Plug in your basic information including the prescription drugs you expect to be taking in 2014. The plan finder will then provide you with a list of stand-alone Part D drug plans (for those with traditional Medicare) and Medicare Advantage plans that are available to you. The list will include the monthly premium, your estimated total annual drug costs and other valuable information.1 In the near future star ratings for plans will also be available to further guide your decision-making.
The Medicare plan finder is a marvelous tool. If you are comfortable using the internet, you will likely have your list of plan options in less than 30 minutes. Those who are less comfortable on the computer can contact 1-800-Medicare, or their State Health Insurance Assistance Program (SHIP), for assistance in comparing plans.
My two-cents: Instead of making a choice based on the insurance company Medicare plan information packages that have been arriving in your mailbox, rely on Medicare itself (e.g. the plan finder) or your state SHIP to find the plan that best meets your needs.
Most People Make Poor Plan Choices
Choosing between Medicare Plans is complicated but oh so important. The Medicare plan finder reduces, but does not eliminate the difficulty in choosing the right plan and making a switch. It still takes some work. But for most of us it is worth the effort to review our plan choices and make any appropriate changes.
Finding and choosing your optimal drug plan is likely to save you hundreds of dollars next year. According to an article in the respected journal Health Affairs the vast majority of Medicare Part D beneficiaries fail to choose the cheapest plans to meet their medication needs. According to the article abstract:
When the Medicare Part D prescription drug benefit began in 2006, a primary concern for some policy makers was whether seniors would be able to make smart choices from among the dozens of competing plans. Using 2009 Part D data, we found that only 5.2 percent of beneficiaries chose the cheapest plan. Nationwide, beneficiaries on average spent $368 more annually than they would have spent had they purchased the cheapest plan available in their region, given their medication needs. More than a fifth of beneficiaries spent at least $500 a year more than they needed to. Beneficiaries often overprotected themselves by paying higher premiums for plan features that they did not need, such as generic drug coverage in the coverage gap. [Emphasis added.]2
Even if you went through the process of finding your best plan last year, it makes sense to do it again this year. Drug plans can change their formulary (drug list), restrictions, co-pays and premiums. The plan that was right for you in 2013, may not be your best choice in 2014.
Don’t confuse Medicare open enrollment with health marketplace enrollment
These days the news is filled with discussion of health marketplace (exchange) enrollment under the Affordable Care Act (aka “Obamacare”). Those marketplaces opened on October 1st. It is critically important for Medicare beneficiaries to understand that the Obamacare marketplace is not for you.
Seniors on Medicare should avoid the health insurance marketplace. The marketplace does not provide Medicare Coverage. If you have Medicare, you already have health insurance coverage. You don’t need the marketplace. The marketplace is not designed for you. See my earlier blog post “What Medicare Beneficiaries need to know about the New Health Insurance Marketplaces” for more information on this subject.
Beware of Scams
Unfortunately, scam artists take advantage of Medicare open enrollment (compounded this year by the confusion surrounding Obamacare and its new health insurance marketplace) to defraud seniors on Medicare.
As noted above, the new Obamacare marketplace doesn’t apply to seniors on Medicare. If someone tells you otherwise and asks for your personal information to comply with the new health care law, you are probably talking to a crook. Don’t give out any information.
You can use a toll-free telephone number (800-318-2596, TTY 855-889-4325) to connect with the federal call centers for reporting fraud or attempted identity theft.
An AARP article3 describes some of the scams that are common during the Medicare open enrollment periods. These include:
1. New card cons. In phone calls and occasionally emails or front-door visits, you're told that Medicare is issuing new cards, and to get yours, you need to provide identifying information such as your Medicare number, birth date or even financial account numbers. Identity theft is the real goal.
What to know: Medicare isn't issuing new cards and its employees don't contact participants through unsolicited calls, emails or visits. They won't ask for personal identifiers unless you contact the agency yourself.
2. Refund rip-offs. Scammers claim you're entitled to money back because of "changes" or "enhancements" by Medicare or private insurers, or because of purported lawsuits or actions by government agencies. In these schemes, the goal is to get not only your Medicare number, but your bank account information for a supposed direct deposit.
What to know: If you're really entitled to a refund, a check will be sent directly to you. You won't have to "prove" or provide anything. If you get Social Security, Uncle Sam already has your direct-deposit account on file, so Medicare wouldn't ask for it.
3. Posers galore. In seeking your personal information, crooks may also claim to be from state or local health agencies, doctor's offices or hospitals, or an official-sounding but phony organization such as the National Medical Office. And they may try to trick you by manipulating your caller ID screen.
What to know: Never trust caller ID. Scammers can easily make it display whatever identity and phone number they choose, thanks to "spoofing" products for sale on the Internet. Also, don't be taken in if callers have personal info about you: Fraudsters have been known to contact Medicare patients and accurately give the names and addresses of their doctors. It's unclear how they got the information.
If you think a call may be genuine, hang up, look up the agency's number yourself and call it back. For Medicare, it's 800-633-4227 (for TTY callers, dial 877-486-2048 toll-free).
4. False freebies. You get a call offering you free medical supplies or a health checkup. The caller may even know something about your medical condition. Or you're invited to go somewhere for a complimentary checkup.
What to know: Assume that an unsolicited call promising supplies for diabetes or other medical conditions is another attempt to collect your Medicare/Social Security number. Or to soften you up for pitches for overpriced goods later. Plus, you may be told your credit card is needed for "shipping charges."
1 Note that your costs may be different depending on any special circumstances that apply to you: such as any Part B premium increase if you have high income, any Part D penalty that may apply, and whether you qualify for Extra Help from Medicare in paying your drug costs.
2 “The Vast Majority of Medicare Part D Beneficiaries Still Don’t Choose the Cheapest Plans That Meet Their Medication Needs.” Health Affairs, October 2012 vol. 31 no. 10 2259-2265: http://content.healthaffairs.org/content/31/10/2259.abstract#aff-2.
3 6 Common Medicare Scams, AARP [last visited, October 7, 2013].