Deadlines For Medicare Coverage Choices

Life Transitions Planning

Open enrollment started on October 15, 2012 for 2013 enrollment. You have until December 7 to pick a Medicare Advantage plan (a private plan that provides medical and prescription-drug coverage) or a Medicare Part D prescription-drug plan for the coming year.

In late September, your current plan should have sent you its Annual Notice of Change, which advises you of any alterations to plan benefits or premiums, or if the plan is being discontinued. This is one piece of mail that you don’t want to throw away.

If you are currently enrolled in a Medicare Advantage plan, you need to be especially vigilant. If your plan does close, you must pick a new Medicare Advantage plan by December 7 or your coverage will shift automatically to traditional Medicare on January 1, 2013. If that happens, you’ll need a separate Part D plan to provide prescription-drug coverage and a Medigap policy to provide extra coverage for deductibles and co-payments. If, however, your Medicare Advantage plan continues to operate, you’ll be re-enrolled automatically in your current plan.

Even if you are satisfied with your current plan, it’s a good idea to review all of your options for next year’s coverage. Some plans will no doubt increase premiums and co-payments and make changes to their drug coverage. For example, your plan may switch some of the drugs you use to a more-expensive pricing tier. That potentially costly change may not be obvious unless you look up the drugs you use on the plan’s list, known as a “formulary.” Consequently, the plan that worked well for you in 2012 may not be the best deal in 2013, and some new plans may provide even better coverage.

You can use the Plan Finder tool at Medicare.gov to compare prices, co-pays, deductibles, coverage and drug tiers for all of the Part D and Medicare Advantage plans available in your area.

Don’t just look at premiums; a plan with low premiums may have higher co-pays and cost you more in the long run. Instead, compare potential out-of-pocket costs of a Part D plan for the drugs you currently take. If you are considering an all-inclusive Medicare Advantage plan, look at the coverage, exclusions and out-of-pocket expenses for the type of medical care you tend to receive.

See A Step-by-Step Guide to Comparing Your Medicare Options for more information about using the Plan Finder tool to pick the best plan for you. Or, you can get personalized assistance with your Medicare decisions through your local State Health Insurance Assistance Program (SHIP). To find local contact information, go to ShipTalk.org or call 800-Medicare 888-663-7407.

During the open enrollment period, you should review your current plan by looking at the costs and coverage for next year to determine if it is still the right plan for you. It is especially important to shop around for the best drug plan. The Washington Post is reporting that prescription drug plan premiums are expected to go up significantly. According to an analysis by Avalere Health, seven of the current top 10 prescription drug plans will have double-digit increases in premiums.

Remember that fraud perpetrators will inevitably use the Open Enrollment Period to try to gain access to individuals’ personal financial information. Medicare beneficiaries should never give their personal information out to anyone making unsolicited phone calls selling Medicare-related products or services or showing up on their doorstep uninvited. If you think you’ve been a victim of fraud or identity theft, contact Medicare. For more information on Medicare fraud, click here or here.

Finally, be sure to sign up for your 2013 plan by the December 7 deadline. Be smart and don’t procrastinate.

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