Alert: Medicare’s annual open enrollment period is coming

Published Aug 27, 2017 at 8:50am

Every year, Medicare’s open enrollment period runs from Oct. 15 through Dec. 7.

For those of you who are new to Medicare, open enrollment is the time when everyone on Medicare can change their health plans and prescription drug coverage for the following year to better meet their needs. What do you need to do to prepare for open enrollment?

September: The first thing you need to do is review any materials your plan sends you. These mailings may include things such as statements of “Evidence of Coverage” (EOC) or “Annual Notice of Change” (ANOC).

If your drug plan is changing, make sure your plan will still meet your needs for the coming year. If you are satisfied with the coverage and cost of your drug plan, you probably do not need to do anything.

In September, your copy of the publication Medicare and You will arrive either through the mail or electronically, depending on your stated preference. Always check this publication for changes in Medicare coverage and costs. Among the things to look for are the rates for Medicare Part B. Also, look for changes in the coverage of medical procedures you currently use or may need to utilize in the next year.

October through Mid-December: Early in October all of the rates for Part D drug plans will be posted on Medicare’s Plan Finder ( website.

Follow the directions and you can find your plan and compare it to others. If you need help using Plan Finder, contact the Oneida County HIICAP program for assistance.

How do I know that my drug plan is still right for me? When considering making the decision to keep your current plan or change to a new one, there are five questions to consider:

Is there a plan that costs less than my current plan?

Does this new plan cover all the drugs that I currently take?

Does this cheaper plan allow me to use the providers I want, including my doctors and pharmacy?

What are the estimated out-of-pocket costs? Are they less, the same or do they exceed the costs of my current plan?

Do the quality and customer service ratings equal or exceed those of my current plan? 

If your answer is yes to all of the above questions, then you may have found a plan that better meets your needs. Still, exercise care when making a change.

The open enrollment period is also the time to make a decision about your Medicare coverage. If you are currently enrolled in Original Medicare with a stand-alone Part D drug plan do you want to change to a comprehensive Medicare Advantage Plan?

Or, if you are enrolled in an Advantage Plan do you want to return to Original Medicare and a Part D plan? HIICAP counselors are available to work with you on making these important decisions.

Finally, although you can make this decision anytime during the year, the open enrollment period is also a good time to review your supplemental or “medi-gap” insurance coverage.

If you change your primary coverage in any way, such as changing your Part D plan, is your current supplemental insurance still the best plan for you? And, if you do not have such coverage, it is certainly the time to consider taking out this important additional coverage.

Extra help. Many people are unaware that they qualify for “Extra Help.”

If you are eligible for this assistance you will get help paying for Medicare prescription drug coverage premiums, copayments, and deductibles. While we do not yet know the income levels you must meet in 2018 to quality, for 2017 you needed to earn less than $17,820 a year ($24,030 for married couples).

Your resources were also limited to $13,640 (or $27,250 for married couples). Resources include bank accounts, stocks and bonds, but not the value of your house or car. There is no penalty for applying and being rejected. 

Have you seen your primary care physician recently? If you need to see your primary care physician, try to make an appointment before the end of the open enrollment period.

There is nothing worse than to schedule an appointment with your physician for January and find out that you need to make major changes in the drugs you take. And, you may find that one or more of these new medications are not covered by your current drug plan.

So, make sure that you are up-to-date on all your required appointments prior to Dec. 7.

Who do I contact in Oneida County to set up an appointment to review my Medicare Part D coverage? This article has only touched on some of the general issues involving your Medicare and prescription drug coverage. Many people just need an answer to a single question while others have much more complex issues.

In every case, the Oneida County Office for the Aging/Continuing Care/NY Connects HIICAP program can help you answer all of your questions and resolve your problems. HIICAP offices are found at the following locations; 

Ava Dorfman Senior Citizens Civic Center, 305 E. Locust St., with hours of operation on Tuesday and Thursday from 10 a.m. to 2 p.m. Again, while consumers are seen on a “first come, first served” basis you may call the Dorfman Center at 315-337-1648 to see if there are long wait times.

North Utica Senior Citizens Community Center, 50 Riverside Drive, Utica with hours of operation on Monday, Wednesday and Friday from 10 a.m. to 2 p.m.

Consumers are counseled on a “first come, first served” basis.

However, if you want to call ahead to see how busy the office is you may call the center’s HIICAP program at 315-724-8680.

HIICAP services are provided by Oneida County Office for Aging and Continuing Care/NY Connects. Anyone with questions about HIICAP, as well as Community Based Long Term Care services and support, should call the program directly at 315-798-5456 and press 4 in the choice list. It will direct you to someone who can assist you.

Dr. William Lane is the owner of William Lane Associates, a gerontological firm which located in Homer, NY. He is writing a monthly column on HIICAP related issues for the OFA. Dr. Lane does not sell insurance, work for any insurance company or recommend any insurance products.