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Medicare Open Enrollment

By Terry Savage on November 12, 2019

For the more than 53 million Americans age 65 and older who are covered by Medicare, there are some important decisions to be made right now.

Medicare’s open enrollment period is underway and runs through December 7. And even if you are completely satisfied with your current Medicare coverage, there are a two things to review during this time period: the relative benefits of traditional Medicare vs. Medicare Advantage, and suitability of your Part D drug coverage.

Medicare enrollment: The basics
You don’t have to do anything about Part A (the hospitalization part) of Medicare. Most people sign up when they become eligible at age 65, even if they are still working and have coverage at work or through a union plan.

The rules for signing up for Part B (physicians, outpatient care, medical supplies, etc.) are a bit more complicated. If you have not yet enrolled for Medicare, you should plan to sign up during the three months before your 65th birthday so Part B coverage will start in the month of your birthday. However, if you’re still working, you can delay signing up for Part B until during the eight-month period after your employer coverage ends. (Note: If your company has fewer than 20 employees, Medicare becomes the primary payer, so you must sign up when first eligible.)

At the time you sign up for Medicare Part B, you should also sign up for Medicare supplement insurance, aka Medigap. If you purchase your supplement within six months of enrolling in Part B, you cannot be denied the most comprehensive coverage for health reasons.

Plus, when you enroll in Part B, you should also sign up for Part D, prescription drug coverage, even if you are not taking any medicine at that point — unless you are getting drug coverage elsewhere.

Open enrollment: What to consider
Now, if you’re already enrolled in Medicare, here’s what you can change each year during the open enrollment period.

—Traditional Medicare A/B or Medicare Advantage
You probably signed up for the traditional package of Medicare Part A and B, plus a supplement and a drug plan. But you could switch to a Medicare Advantage program, which basically rolls all these coverages into one monthly premium. These Advantage plans are being widely advertised now, and they tend to be less expensive than purchasing the separate parts. Plus, there are no billing headaches.
But there is a catch: You are limited to receive services by the physicians and hospitals inside the plan’s network. If you seek a second opinion outside the network, or want treatment that is given at another hospital, you will not be covered! Think carefully about making this decision.

During Medicare open enrollment you can switch from traditional Medicare to a Medicare Advantage program — or vice versa. But the catch here is that if you are switching back to traditional Medicare you may not be able to get the best Medicare supplement plan if you have a pre-existing condition at this point. That could leave some very expensive costs uncovered.

—Changing Part D: Prescription drug coverage
Reviewing your Part D coverage is something everyone who has Part D should do every single year, even if your prescriptions haven’t changed. That’s because each year the Part D insurers change their premiums, drug prices and drug formularies. So, under your current plan your meds might not be covered in the coming year. Or they might become much more expensive. Or the plan might no longer include the pharmacy that you like to use.

It’s easy to find out which is the best Part D program for your personal situation. Just go to Medicare.gov/plan-compare. There you can enter all your current medications and find the least expensive plan for 2020. (Tip: Line up the prescription bottles in front of your computer so you enter the exact drug and dosage amount.) If you created an account last year, they’ll have your drug history. There is even a “live chat” feature if you want to ask questions. You can choose and enroll in your new Part D plan instantly on the Medicare.gov website.

These two big decisions — about moving to or from Medicare Advantage, and reviewing your Part D drug plans –must be made by December 7th, so don’t procrastinate. Otherwise you could make a costly mistake. And that’s The Savage Truth.

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