People with Medicare Should Review Their Health and Drug Coverage Options Carefully

Medicare’s Fall Open Enrollment Period is October 15 through December 7, and the Medicare Rights Center urges everyone with Medicare who is enrolled in a private health or drug plan to use the Fall Open Enrollment Period to review their choices. Because plans make changes to their benefit packages every year, even people who are currently happy with their plan should review their coverage. Those enrolled in Original Medicare can also decide at this time to switch to a private plan, or choose a new stand-alone drug plan. During the Fall Open Enrollment Period, Medicare beneficiaries have the right to make as many changes as they need, and the last change they make on or before December 7 will go into effect on January 1, 2014. “Medicare beneficiaries need to be aware of any changes to their current plan and carefully review all of their options in time to make a decision by December 7,” said Joe Baker, President of the Medicare Rights Center. “While reviewing your options, it is important that you contact the plan to confirm any information you find. Once you have made your decision, you can enroll in the plan by calling 1-800-MEDICARE.” The Medicare Rights Center urges people to consider the following questions before enrolling in a Medicare Advantage or stand-alone prescription drug plan: • Will I be able to use my doctors? Are they in the plan’s network and are they taking new patients who have this plan? • Which specialists, hospitals, home health agencies and skilled nursing facilities are in the plan’s network? • Who can I choose as my Primary Care Physician (PCP)? • How much is my monthly premium? • Do I need a referral to see a specialist? • Are my prescription drugs on the plan’s formulary (list of covered drugs)? • Does the plan require that I get “prior authorization” before my prescription will be covered, or impose other restrictions (like limiting the quantity or requiring that I try a cheaper medication before it will cover a more expensive one)? • How much will I have to pay out of pocket before coverage starts (what is the deductible)? • How much will I pay for brand-name drugs? How much for generic drugs? • What service area does the plan cover? • What kind of coverage do I have if I travel outside of the service area? Use the Medicare Plan Finder tool at www.medicare.gov or call 800-MEDICARE to review your options and get details. Medicare Rights recommends that beneficiaries call the plan to confirm the information they find, and keep a record of the conversation with the plan representative. Medicare Rights also recommends enrolling in a plan by calling 800-MEDICARE rather than the plan itself. State Health Insurance Assistance Programs (SHIPs) also provide free counseling services. To find your local SHIP, go to shipnpr.shiptalk.org or call 800-677-1116.