Open Enrollment – More Than a Tsunami of Ads and Information

In four days, October 15^th, the open enrollment period for making changes to your current Medicare coverage begins. It will end on December 7^th (click here if you are just turning 65 for information on Medicare initial enrollment). The open enrollment period for switching from one Medicare Advantage plan to another or switch back to original Medicare is January 1^st to March 31^st.

You may have already deduced that it was that time of the year given the beginning of the insurance ads that will soon become a tidal wave of pleas to choose one form of Medicare insurance or another. It attacks our TVs, our email, our phones, and our mailboxes. While these ads use the usual hyperbole to make their product sound best, there is one fact that we shouldn’t ignore, it is in our best interest to take the time during this enrollment period, to review our Medicare insurance. The sad fact is, only one in four people take the time to review their Medicare coverage options, an oversight that could not only affect their pocketbook but also their health.

The many insurance ads tout the positive aspects of each insurance plan based on a general customer with health issues that fit their product most favorably. Even basic Medicare employs a one size fits all sort of coverage. The fact of the matter is, the best coverage for you depends on some very specific facts about you, your health and your family’s health history. Choosing Medicare health insurance without knowing these specifics facts is like buying an airline ticket before you know where you’re going. The good news is the airline website won’t let you buy a ticket without first telling it where you’re going. The bad news is no one can force you to consider your specific health facts before they allow you to purchase their insurance plan.

Hopefully the question has jumped into your mind, “what information should I know and what info should I gather before I begin a review of my insurance plan?” I’m glad you asked. Here are some steps to get prepared:

1. Watch this video on the basics. Once it is over there are many other videos offered that will go into more detail on a variety of related subjects. Another good information resource is here.
2. Gather information about your existing Medicare coverage like: premium costs, deductibles, co-pays, co-insurance, out-of-pocket caps, etc.
3. Assemble information concerning what doctors you use, pharmacy preferences, the drugs you take, the cost of your drugs, and what special ongoing services you require.
4. Document if there have been any changes to your health have occurred this year.
5. Are you anticipating the need for dental or vision care next year?
6. What Illnesses are historically prevalent in your family?
7. Decide if it has been difficult to pay for the costs of your healthcare this year.
8. Will you be traveling extensively within the U.S. or to foreign countries?

This information will help you as you review the different plans. There are two main types of Medicare insurance, Medigap (or Medicare supplemental insurance) and Medicare Advantage. As you review these many options it is important that you check that your doctors are in the plan’s network, that the prescription drugs you take are in your plan’s formulary and you know the cost of those drugs in each plan. How does the plan cover preventative care? What is the plan’s mental health coverage? How do they cover illnesses that are historically prevalent in your family? Don’t be afraid to talk with your doctor about any of these questions. It’s this type of specific information and questions that can ensure you get the best possible insurance for you. I have a few other points that might help.

First, there are legitimate and trusted resources that can help you with your decision. The difficult task is to find someone who is knowledgeable of the different insurance options but to understand if they are affiliated with (read paid a commission by) a particular company. State Health Insurance Assistance Programs exist in every state. You can find more information here.

Second, if you search online for Medicare coverage you will find many websites that look like they are government sponsored or affiliated. They will want to give you information on Medicare but will ultimately want to sell you their insurance. Even ads on TV will sound like they are government affiliated or are neutral in their insurance recommendations. Be skeptical, avoid going to websites labeled ads and go directly to a company’s website. Use the Medicare Prescription Drug Plan Finder to find the Part D plan that is right for you.

Healthcare is complicated, I wish it wasn’t, but it is. We can either stick our heads in the sand or decide that we can have some control on this aspect of our life and work to find the plan that fits us the best. The tools that allow us to make the correct decision are available – we just need to decide that we are going to be the one of the four that uses these tools to review our Medicare coverage.

Best, Thair