Every year Medicare offers open enrollment for members to make changes to their plans if they need to do so. Medicare health and drug plans can make changes each year-things like premium and co-pay costs, coverage, and what providers and pharmacies are in their networks. You have the option to review, compare and to switch to another plan if you need to.
This period called Open Enrollment Period is from Oct. 15 to Dec. 7 each year when people with Medicare can change their Medicare plans for the following year to better meet your needs. New changes made in this enrollment period will become effective Jan. 1 for the 2018 year.
People in Medicare health or drug plans should review the materials received from your plans like the Evidence of Coverage and Annual Notice of Change. If your plans are changing, you should make sure your plans still meet your needs for the following year. If you’re sure your current plan will meet your needs for next year and it’s still being offered, you need to do nothing.
During this Open Enrollment Period Medicare members can switch from one Medicare Drug plan to another. If you didn’t enroll in a Medicare Part D plan when you were first eligible you can do so during the open enrollment period, although a late enrollment penalty might apply.
Medicare changes in the prescription drug plans will include better discounts in the donut hole. The gap or donut hole starts when the initial coverage limit of $3,750 is reached and ends when you have spent $5,000. The donut hole has been closing steadily and will be fully closed in 2020. For 2018 costs while in the donut hole will be 35 percent of the cost on name brand drugs and 44 percent of the cost of generic drugs. The Medicare Part D deductible will be $405 in 2018 on some plans.
Most Medicare beneficiaries should receive your Annual Notice of Change and Evidence of Coverage from your providers this month. It is important to review this information carefully since it will cover changes to your plan. For example, increasing premium cost, deductible, co-pays and drug formularies will be outlined in this notice.
If you meet certain income limits, you may qualify for Extra Help from Medicare to pay the costs of Medicare prescription drug coverage. If you don’t qualify for Extra help, your state may have other programs that can help pay your prescription drug costs. Contact your State Health Insurance Assistance Program or local SHICK counselor for assistance.
Some people automatically qualify for Extra Help. You automatically qualify for Extra Help if you have Medicare and meet any of these conditions:
— Have full Medicaid coverage
— Get help from your state Medicaid program paying your Part B premiums (Medicare Savings Programs)
— Get Supplemental Security Income benefits
Even if you automatically qualify this year, you may not qualify for Extra Help next year. Changes in your income or resources may cause you no longer to qualify for one of the programs listed above. You’ll get a notice on grey paper by the end of September if you no longer automatically qualify. Even if you get this notice, you may still qualify, but you need to apply to find out.
To get assistance with enrollment for Medicare Benefits including Health and Prescription Drug plans contact Medicare at 1-800-Medicare or Medicare.gov.
McPherson County Council on Aging offers SHICK counseling. Call 620-241-4383.