On Medicare – Annual Enrollment Dos and Don’ts

Medicare’s Annual Enrollment Period (AEP) began 10/15 and will continue through 12/7. The AEP is when most people can change their Medicare Advantage (MA) and Medicare Drug Plans (Part D).  So, that is the reason for the flood of commercials, mailings and perhaps phone calls you may be receiving.  What do you need to know?

DOs: If you have an MA or Part D plan you received from your insurance company an “Annual Notice of Change packet (ANOC) of information of coverage for 2019.  These plans can change yearly, so DO review your plan’s annual renewal information carefully.  Some people may receive a letter from their MA or Part D company discontinuing their plan for 2019. If this happens to you, you will need to take some action or you will be put back into original Medicare or lose a Part D Plan by default.  On the other hand, this letter will guarantee that you can move to a plan with any insurance company in the state – DO keep this letter, do not throw it away.  You will need to take an action.

After you review 2019 ANOC information, if you have an MA Plan, DO review your benefits. They probably have changed from 2018.  Also confirm your providers are still in the network of covered providers.  Provider networks can change.  If drugs are covered under your plan, DO make sure your drugs are covered; look for any restrictions (i.e.: quantity limits, step therapy and prior authorization.  Ideally, your pharmacy is a preferred pharmacy for your cost savings. Especially look at your at the 2018 co-pays compared to 2019’s.  DO contact your agent or insurance company if you have questions.

DON’TS: Make changes in your plans when you have not done research. Just because a friend or sibling has a certain company or plan, it does not mean that you should have the same company or plan.  DON’T take incoming phone calls from people selling Medicare Plans. First, if they are not currently doing business with you and if they are calling about MAs or Part D plans – their call may be illegal. If you wish to speak with a friend’s agent, you must initiate contact by calling that agent.

DON’T give out personal information by phone. If someone is calling you and you do not know them, protect yourself. While Medicare #s are being changed so they do not include your Social Security #, still DON’T give them your Medicare #.  DON’T provide them specifics like your address, date of birth, bank or credit card information or even your health issues.  And DON’T accept feeling pressured.  DON’T buy a plan without seeing (in writing) that your providers or drugs are covered.  In addition, DON’T give an insurance company a check at time of enrollment/application.  MA and Part D plans require the consumer to be billed and they should not accept any checks upon application (exception is a void check for electronic withdrawals).  However, Medicare Supplements or Gap-fillers may accept the first payment.  Medicare Supplements (also called Gapfillers) are insurance plans to cover the gaps in Original Medicare.  In which case make the check payable to the insurance company.

More DOs: In this writer’s opinion, DO work with local insurance agents. They know the local environment and should be available, even in person, when you need them.  An insurance company and agents from other parts of the country are not familiar with the local medical network systems.  Local agents can be researched through a local professional organization named “Central IL Health Underwriters (www.CIAHU.org.).  

In addition, more DOs: as a general practice; be an advocate for yourself.  Usually, there is nothing “free”. Ask questions and understand why one insurance product may cost substantially less than another.  Keep track of your medical appointment dates and bills. If something does not appear correct call the provider.  Watch your insurance explanations of benefits; match them up with your bills.  If something does not look right, call your provider, Medicare or insurance company.  Medicare has a hotline 1-800-633-4227.

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