What You Should Consider During Open Enrollment

prescription drug plans

Medicare has a number of enrollment periods, including the initial enrollment period, general enrollment period, special enrollment period, and an Annual Election Period. The Medicare Annual Election Period is from November 15 until December 31, 2010. During this enrollment period you can enroll in Medicare, add, drop, or change coverage.

You need to consider all the aspects of your plan and compare it to other plans during this period. There might be a plan that works better for your medical needs. If you have Original Medicare and Medicare Part D Drug Plan there might be a Medicare Advantage Plan that would work better for you. Likewise if you have a Medicare Advantage Plan you might find that changing to Original Medicare works best.

If you are enrolling in Medicare for the first time you should take into account medical services, providers, and prescriptions you use now. If you wish to continue with those providers and prescriptions you need to find a plan that covers them.

You should also take into account costs: examine the various plans to determine if you could save money with one plan over another. Having “creditable” prescription drug coverage is always advisable. If you are without it for more than 63 days you can wind up paying a late enrollment fee.

When you decide on a plan and complete the Medicare application in the Medicare Annual Enrollment Period, your plan takes effect January 1. You can usually complete a paper application or online application. You can also call Medicare. When you call, be sure to have your Medicare number as well as the dates your Part A and Part B coverage began.

Switching plans during the Annual Enrollment Period is as simple as picking a new plan and signing up. There is no need to inform your old plan or even contact them. That coverage will end when your new coverage begins.

There are other times, outside the Annual Enrollment Period when you can change plans. You can also move from your Medicare Advantage Plan to Original Medicare between January 1 and February 14, 2011. If you make this switch you also have until February to join a Medicare Prescription Drug Plan. Coverage begins the first day of the month following when your plan gets your enrollment form.

It is important to note there are some things you cannot do from January 1 to February 14, 2011. You cannot switch from Original Medicare to a Medicare Advantage Plan.

  • You cannot switch from one Medicare Advantage Plans to a different one.
  • You cannot switch from one Medicare Part D Prescription Drug Plans to another.
  • You also cannot join, switch or drop a Medicare Medical Savings Plan.

These Medical Savings Account Plans are a combination of a bank account and a high deductible health care plan. Money, generally less than the deductible, is deposited in the account and you can use the money for health care throughout the year. Of course you should be aware that this plan, because of the high deductible, might not be right for you in any case.

Usually you have to stay in a plan for one calendar year. For example, if your plan starts in February you need to remain in that plan until the following February. There are some exceptions to this with regard to Medicare Advantage Plans. They often have specific geographic areas where the plan is available. If you move outside the plan’s service area you may change plans. If you qualify for Extra Help you can change plans at other times. Extra Help is for Medicare recipients with limited resources and income. You can also sometimes change if you live in a nursing home or certain other institutions.

There is also an Annual Election Period for Medigap/Medicare Supplemental Plans. This period starts during the first month that you are 65 and are enrolled in a Medicare Part B Plan (Part B is Medical Insurance as opposed to Part A which is hospital insurance). The period runs for six months and offers you an opportunity to buy any Medigap/Medicare Supplemental Plan sold in your state. If you wait to buy a Medigap/Medicare Supplemental Plan beyond the six month period, the policies you can purchase may be limited and the cost higher. Please note that most who have Medicare Advantage Plans may want to drop Medigap/Medicare Supplemental Plan coverage since it cannot be used to pay Medicare Advantage Plan copayments, deductibles, or premiums. If you drop Medigap/Medicare Supplemental Plan coverage to join a Medicare Advantage Plan you most likely will not be able to get your Medigap/Medicare Supplemental Plan back.

Another thing you should be aware of with regard to a Medicare Advantage Plan is that no one should call or come to your home to sell you a Medicare plan. If someone does, do not give them any personal information. You should only give such information to doctors, health care providers, and plans approved by Medicare.

Medicare plans are not allowed to ask you for financial information like credit card numbers or bank information over the phone or via email unless you are already a plan member. You cannot be enrolled in a plan over the phone unless you contact the company to enroll. If they call you, you should be suspicious. To fight fraud be sure to ask questions, educate yourself about Medicare, and beware of providers who discuss items that are not covered, but suggest they can get coverage for those items.

If you feel someone has taken advantage of you contact Medicare. You can call 1-800-MEDICARE for help or contact the Medicare Drug Integrity Contractor (MEDIC) at 1-877-7SAFERX (772-3379). There is also the Senior Medicare Patrol Program which is dedicated to fighting fraud and abuse. They operate in all U.S. States and many territories. You can contact them at 1-877-808-2468.