Medicare’s Annual Enrollment Period Starts 10/15

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Medicare Advantage (MA) and Medicare Drug Plans (Plan F)

Medicare’s Annual Enrollment Period (AEP) will begin 10/15 and continue through 12/7. The AEP is when most people can change their Medicare Advantage (MA) and Medicare Drug Plans (Part D). So, what do you need to know?

MA plans can change every year, therefore review your plan’s annual renewal information carefully. Some people may received a letter from their MA or Part D company discontinuing their plan for 2013. If this happens to you, you will need to take some action or you will be put back into original Medicare by default. On the other hand, this letter will guarantee that you can move to any plan in the state – keep this letter, do not throw it away.

Your options include: moving to any Medicare Supplement company regardless of your health (you will also need to buy a Part D MedicareRX plan), move to another type of MA plan (may include prescription coverage). What’s best for you? This is where you need to talk with an insurance agent who specializes in Medicare Plans. Some suggest a broker who handles a number of companies would be best so that he/she could recommend the company and plan that best fits your situation. Make time to understand the benefits, limitations, exclusions, restrictions and drug formulary within any plan you consider plan.

What should you know when you gather information? If you consider a Medicare Supplement consider size and stability of the company, including premium history. Know that with a Med Supp you will most likely also need a Medicare Part D Plan. Make sure the prescriptions you take are covered under that plan.

Concerning MA plans: MA plans are a viable option to cut premium costs and in many cases, overall costs. Be sure to look and understand the maximum out of pocket and how it works. Realistically consider your own health and health risk. MA plans have co-pays and co-insurance, meaning you will pay a portion of your doctors, hospital and most other provider costs. If you are using oxygen or have a high likelihood for surgery and hospitalization, you may pay more money in co-pays out of pocket for an MA than you would pay with the increased premium of a Med Supp.

Next look at the type of plan (understand the restrictions) and the provider network. If your doctors are not in the provider network, chances are you will not be happy with an MA. Then do the math and consider your risk tolerance when you consider a plan for 2013. Fill in the gaps on each side:

Med Supp | MAPD: __________

Annual premium: ___________________________

Ann. Part D premium: _________________________

Any deductibles: _____________________________

Doctor copays: ________________________________

Specialist copays: ________________________________

Other projected expenses: _____________________________

Total projected out of pocket expense: __________________________

In summary: know your risk tolerance and project your total out of pocket costs. Call your agent, a professional agent who specializes in Medicare Plans. Do not wait, 2013 information is available now. You can make changes and enroll in plans 10/15 – 12/7. However, it is wise to complete this process no later than December 1st.

Also, you can use as resources: Medicare at www.medicare.gov and/our website at www.MRMS-INC.com for various issues including information on Medicare and Medicare Plans.

Written by

Steven A. Buttice is the president of Medical Reimbursement & Management Services, Inc., a firm specializing in issues affecting seniors, including seminars and consultation on Medicare Plans, Long Term Care and other types of insurance, claims issues, and sales/service of insurance products since 1984.

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