Medicare Open Enrollment

Posted on October 16, 2019   |   
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It is officially time for Medicare Open Enrollment. Starting from October 15 through December 7 you can review your current coverage, select different Part D drug plans, change between Original Medicare and Medicare Advantage and more.

EVERYONE who is enrolled in Medicare should check on your coverage during Open Enrollment, even if you are 100% satisfied with the service and benefits from your existing plans. Medicare rules shift slightly nearly every year and plans can and do change up their rules, covered services and out of pocket requirements.

We reviewed what you should know about Medicare Open Enrollment and how COPD care is covered during our October 10th webinar, Medicare Open Enrollment: What People with COPD Need to Know. If you missed the webinar, you can still benefit from the outstanding presentation provided by Laurie Thomashow of the Medicare Rights Center.

Click here to access the recording. You can view the slides without the recording here.

There are abundant resources out there to help you navigate the process so that you end up with the right types of plans to match your individual health needs and financial situation. There is NO one size fits all answer for what plans someone with COPD should enroll in, so do your homework, use the resources available to you and put yourself in the best possible position going into 2020.

Here are a few of the resources you might find helpful in addition to the Webinar Recording.

  • The Medicare Rights Center: Visit their website at https://www.medicarerights.org/ and check out their Blog for topics such as an overview of the new Medicare Plan Finder Tool, their Medicare Interactive for help navigating health insurance and use their helpline for phone support.
  • State Health Insurance Assistance Programs: Find local support by visiting https://www.shiptacenter.org/ or calling 1-877-839-2675. They can connect you to free support in your area.
  • The BenefitsCheckUp Tool at https://www.benefitscheckup.org/ is a project of the National Council on Aging. The web tool connects you with programs that may provide financial assistance for prescription drugs along with many other necessities.
  • Medicare.gov: Medicare.gov is the go-to site to review your current coverage, enter your medications to assess out of pocket costs in 2020 and enroll in Medigap or Medicare Advantage plans.

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  • There were two questions asked before and after the webinar. Here are some thoughts from Laurie on these issues. Don't hesitate to post your questions and share your tips for others! Also, remember that Open Enrollment time can also be prime time for fraudsters, so take precautions and never give your personal info out on the phone unless you are absolutely sure it is a valid request. Learn more about when Medicare will call you at https://www.medicare.gov/forms-help-resources/identity-theft-protect-yourself.

    Question from webinar: Is there any recourse in a Medicare Advantage Plan if a primary care professional refuses to give a patient a referral to a specialist?

    Laurie’s answer: First explore if the specialist would be in-network. If they are in-network, there could be many reasons eg. not medically necessary. A patient can file a grievance with the plan, and/or ask for a new PCP. During fall open enrollment, the patient can also shop around for a different Medicare advantage plan with a different doctor that may better meet their needs. Another possible option would be to think about switching to Original Medicare with a supplement and a separate Part D plan. In that case there would be no need for referrals to specialists. The patient could see any specialist that takes Medicare without a referral.

    Question from Social: Will I be able to switch back to Original Medicare and still purchase a supplement plan without having to pay more for pre-existing conditions?

    Laurie’s answer: If folks are looking to switch from Medicare Advantage plan to sign up for a Medigap/supplement and Original Medicare with a standalone Part D plan, they would want to contact their State Health Insurance Assistance Program to ask about medigap rules in their state. Here is a website where they can find those numbers: https://www.seniorsresourceguide.com/directories/National/SHIP/

    Reply

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