With the deadline for Medicare’s open-enrollment season scheduled Dec. 7, now is the time for people with Medicare to review their Medicare health and prescription drug plans carefully.
These plans can change from year to year. Premiums can go up and drugs can be dropped, so it’s important to make sure that your plan still meets your needs in terms of cost, coverage and convenience.
During open enrollment, you can join a plan or cancel one that no longer suits you.
A good way to shop for a new plan is to visit the www.Medicare.gov website. Click “Compare drug and health plans.” Using the Medicare “Plan Finder” tool, you can plug in your zip code and see a list of plans that provide coverage in the area.
“Plan Finder” shows a plan’s monthly premium, deductible, whether you have to go only to doctors in the plan network and your estimated annual health and drug costs.
The “Formulary Finder” tool on the Medicare website allows you to enter the medications you’re currently taking and search for Medicare Part D plans that cover them.
Information on health and drug plans in the area also can be found in the “Medicare & You” handbook, mailed each fall to every Medicare beneficiary.
Or you may want to call the toll-free help line, (800) MEDICARE. Customer representatives are available 24 hours a day, seven days a week to help walk you through your health and drug plan options.
If you prefer face-to-face counseling, that’s available, too. Call (800) 434-0222 for an appointment with a representative at the closest office of your State Health Insurance Counseling and Assistance Program (HICAP). Counseling is free. Many of the HICAP counselors are Medicare beneficiaries themselves, and they can help with a wide variety of questions, including enrollment.
The good news for next year is that average premiums for Medicare Advantage health plans are expected to be 4 percent lower than this year. Average premiums for Medicare prescription drug plans should be appoximately the same next year.
Due to the Affordable Care Act, people who enter the coverage gap, or “donut hole,” in their Part D drug plan will be able to get a 50 percent discount on new drugs.
In addition, preventive health services will be accessible at no out-of-pocket cost. These services include cancer screenings and a new annual wellness visit with your doctor. During this visit, you and your doctor can discuss your health status and develop a personalized care plan.
We have begun to rate Medicare Advantage plans based on our Five-Star Rating System. This year, for the first time, you’ll see a gold star icon designating the top rated five-star plans. You’ll also see warnings for plans that are consistently poor performers.
I encourage all Medicare beneficiaries enrolled in private plans to know their plan’s overall star rating and to consider enrolling in plans with high ratings. When comparing plans, you should consider the plan’s quality in addition to its costs, coverage and other conveniences.
Part D plans also receive quality ratings.
David Sayen is Medicare’s regional administrator for California. For more information, call (800) MEDICARE.