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Things to Consider When Choosing Your Medicare Plan This Open Enrollment

Open Enrollment is here again. We have the opportunity to review our Medicare Part D coverage to make sure it is right for us. From time to time, I have heard people complain that this yearly process is annoying and unnecessary, but I beg to differ. In the course of a year, many things can change – from where we live to the medicines we take. The open enrollment period is an opportunity to ensure we have a plan that best meets our current needs.


Plans themselves can also change from year to year. For example, this year, my plan will no longer have a preferred relationship with my pharmacy. If I stay with my current plan and keep the same pharmacy, my medicines may cost more, and I will be taking that into account as I make my decision about what plan will give me the most value.


Other possible plan changes may have an even bigger impact on your purse. Be sure to compare the list of medicines you take with the list of medicines your plan will cover because the list may be different than last year. Also, double-check that all or at least most of your medicines are listed. Don’t just pick a plan because the premium is low. If the medicines you need aren’t covered, you could end up paying more.


You should also consider the amount your plan will pay toward the cost of your medicines. Most of us are familiar with co-payments – the fixed amount you pay when you visit a doctor, get a health service or, in this case, pick up your medicines – but beware, some plans have co-insurance rather than co-payments for some medicines. Co-insurance requires that you pay a percentage of the cost of a particular medicine rather than a fixed amount like the co-payment. From year to year, plans may change their formulary (the list of drugs they cover) and cost-sharing levels so that a drug which last year only required a co-payment may now require co-insurance. Because this will change the amount of money you will need to pay, it is really important to review your plan to see what coverage is provided.


When Medicare Part D was created, many patient groups and consumer advocates worked hard with CMS (the agency that runs Medicare) to make sure that Medicare beneficiaries would be able to get the medicines they need. The Open Enrollment process is one of the most important safeguards of this program because it guarantees that every year we can decide which plan works best for us.


So, PLEASE review your plan and make an informed decision during Open Enrollment. Visit the Medicare website ( and use the plan comparison tool to see what options you have or go to the Medicare
SHIIP Counselor at your local Area Agency On Aging. You can also call Medicare all day, any day except Federal holidays at 1-800-633-4227.


Tell us what you found when you reviewed your plan. Did you decide to make a change? Did you get advice from anyone? What advice do you have for others reviewing their plans?


Remember– Open Enrollment ends December 7.