Tips for the Medicare Annual Enrollment Period

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If you are age 65 or older, you are about to get bombarded with Medicare marketing messages.

The Medicare Annual Enrollment Period, also known as “AEP,” begins October 15th and ends December 7th.  During this time, people can make changes to their Medicare plans.  Any changes made during AEP become effective January 1st of the upcoming year.

If you are enrolled in a Medicare Advantage Part C plan or a Part D prescription drug plan, AEP is the time of year that you really should be evaluating your insurance coverage to make sure you understand what changes, if any, might impact you.

Whether it is through television, telemarketing or direct mail, Insurance companies or lead aggregators (aka “Joe Namath commercials”),  brokers turn on their marketing spigots during AEP in an effort to get Medicare beneficiaries to change their plans, regardless of whether a change is needed or not.

Before you or someone you know make a change to your Medicare plans that might be regretted in the future, here are a few tips to help you navigate AEP more effectively and with less stress!

Part D Prescription Drug Plans

If you are enrolled in a stand-alone Part D prescription drug plan, it is important to re-evaluate your coverage every year.

Your prescription drugs might change from year-to-year and the Part D plans, including their monthly premiums, deductibles, co-pays and most importantly their formularies (list of drugs they cover) WILL change from year-to-year.

It is important to work with your Medicare advisor to review your current list of prescription medications, along with your preferred pharmacy, and sort through all the Part D plans available in the service area where you live.  A quality Medicare advisor will ideally work with all the available Part D plans and have access to software to assist with comparing those plans to make a recommendation for the upcoming year based upon total projected cost.

Medicare Advantage Part C Plans

Since there are more moving parts to Medicare Advantage plans, because they bundle medical and prescription benefits into one plan, there are more things to consider:

  • Network – Are all your providers in-network for the upcoming year?
  • Cost Sharing – Will there be changes to your plan’s the annual deductible, co-pays/coinsurance or maximum out-of-pocket for the upcoming year?
  • Prescriptions – Review your list of medications to make sure there will be no surprises
  • Extra Benefits – Does your plan offer the right coverage for dental, vision, hearing aids, fitness, etc.?


MediGap Plans

If you are enrolled in a Medicare Supplement, also known as a MediGap plan, you probably do NOT need to review this every year.

Although premiums for MediGap plans tend to increase slightly each year, the benefits do NOT change from year-to-year.

Also, most states* are not considered guaranteed issue, meaning that a person probably needs to go through medical underwriting to qualify to change MediGap companies.

Be Wary of Medicare TV Advertisements

Most of the television ads permeating the airwaves, such as the Joe Namath and JJ Walker ads, promote 1-800 numbers for national call centers or lead aggregators.

The sole purpose of these call centers is to get you to change your plan, regardless of whether your current plan is the right plan for you for the upcoming year.

These companies rarely work with local insurance companies, and they historically have not done a good job reviewing people’s prescriptions and medical providers to make sure their recommended plan is truly suitable for a person’s needs.

In fact, the customer service of these companies has historically been so poor that the Center for Medicare Services has come out with new regulations to monitor the activities for over-the-phone sales activities beginning with the upcoming AEP.

Rather than calling these 1-800 numbers, I really want to encourage you to connect with one of our Member Agents.  After reviewing your needs, they will help you decide if you should keep what you have or if you should consider making a change.

As always, there are never any fees for their educational or enrollment services!

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