Take Advantage of the Medicare Annual Enrollment Period

financial advisor

By Joe Globensky, RFC®

Medicare Annual Enrollment

The Medicare Annual Enrollment Period (AEP), also known as Open Enrollment, began on October 15th and runs through December 7th.  This is the one opportunity each year that most people on a Medicare stand-alone Prescription Drug Plan (PDP) can change their plan for the coming plan year. 

While those on a Medicare Advantage (MA) plan can make changes during AEP, MA plans also have their own Open Enrollment Period that runs from January 1st until March 31st.  Thereby providing Medicare Advantage members a second opportunity to change their plan if they missed their chance during AEP.

We highly encourage all MA and PDP members to comparison shop their plans during Medicare Annual Enrollment, as these plans change every year.  These can include changes to covered drugs, changes to drug deductibles and co-pays, premium and/or benefit changes and changes to doctor/hospital networks.  Let me give you some examples of why we suggest this.

Drug Formulary Changes

While a prescription drug may be covered on your plan’s drug formulary this year, there is no guarantee that it will be in the new plan year.  With the rising costs for some medications, it is common for plans to make changes to their covered drugs.  This could drastically affect you and your budget, especially if there are other drugs in the same classification.

Even a plan that has served you well for years can make a formulary change that could end up costing you hundreds, possibly thousands, more.  Taking time to comparison shop your plan during the Medicare Annual Enrollment Period can help save you money.  And, if you don’t have the time to do the work, an independent insurance agent can help with this process.

Drug Deductibles and Co-Pays

Did you know the 2022 annual deductible for most stand-alone PDPs is increasing from $445 to $480?  And, while there are PDPs that offer lower or no drug deductible, this doesn’t necessarily make them the RIGHT plan for you.  When shopping for a plan, you need to account for the total cost for the year.  The total cost includes your monthly premium, any drug deductible, and your drug co-pays and/or co-insurance, especially if you fall into the Coverage Gap (Donut Hole) or Catastrophic Coverage.

With the rising cost of medications, your drug co-pays can change year after year, sometimes significantly.  There may also be price differences between preferred network pharmacies and/or mail order.  And just because your plan offers a mail order option doesn’t necessarily make it less expensive than a local pharmacy.  Make sure you know the ways you can save money on your prescription drugs.

Premium and Benefit Changes

Medicare Advantage members benefit from coverage for things like routine dental, vision, and hearing.  The Annual Notice of Change (ANoC) documents how your current plan is changing in the new plan year.  This should be reviewed thoroughly so you can stay on top of these changes and how they might affect your decisions.

For example, let’s say you have been putting off that dental procedure for various reasons.  You review your ANoC and find out your current dental plan’s benefit is being reduced in the new plan year.  You can comparison shop to see what other MA plans offer.  You could also decide to keep your current plan and just get that procedure done in the current plan year before the benefit is lowered.

Doctor/Hospital Network Changes

It’s possible your current Primary Care Physician or favorite local hospital could leave your plan’s network in the new plan year.  Imagine your surprise the first time you go to the doctor in the new plan year and find this out the hard way.  A simple provider search during AEP can help ensure this doesn’t happen to you.

If you find that your provider(s) will no longer be in your current network, comparison shopping during AEP may allow you to find a comparable plan where your providers are in-network.  At the very least, it gives you time to find a new provider in your current plan’s network before the start of the new plan year.

Valuable Resources

DIY Resources

For those wanting to do it themselves, your first stop should be the Medicare website.  Here you can search plans in your area for the new plan year.  If you have a login to the site, you can save your prescription drug list, making the search easier in future years.

Once you have found your current plan and some possible alternatives, I strongly suggest you confirm all pricing information on the respective insurance company websites.  If you click on the plan details button on the Medicare website, there will be a link to the plan website.

For those on MA plans, make sure to review the Summary of Benefits for the plan(s) you are considering.  While the Medicare website is informative, it falls short on things like dental, vision, hearing, and over-the-counter (OTC) benefits the plans may offer, specifically the dollar amounts of those benefits.

Professional Resources

As an independent insurance agent, I always suggest people use my service and experience to help keep as much money in their pockets as possible.  If not me, another agent with Medicare health plan experience is better than trying to do it yourself.

And did I mention that plan premiums are the same whether you do all this work yourself, or you have an agent do it for you?  Make sure you are taking advantage of all the resources available to you during the Medicare Annual Enrollment Period.  And get moving!  December 7th will be here before you know it.

At Connections Financial Advisors, we create a truly comfortable and educating experience as we empower you to meet your financial goals.  This includes helping clients with financial and retirement planning, investment management, and personal risk management services like Medicare health plans.  If you are ready for help, please give us a call at (217) 605-8130 or send us an e-mail.  You can also now use our online calendar to schedule an in-person, virtual or phone meeting on a day/time convenient for you.  We look forward to serving you.

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