What does Annual Medicare Enrollment mean for You?

Every year, as you approach age 65 or if you are beyond that age, you start getting bombarded with ads about Medicare enrollment starting in August.  If you are like most people, you probably stop paying attention after the first few years.  That might not be in your best interest.  Here is some distilled information for you to consider, depending on your age.

Every year, as you approach age 65 or if you are beyond that age, you start getting bombarded with ads about Medicare enrollment starting in August.  If you are like most people, you probably stop paying attention after the first few years.  That might not be in your best interest.  Here is some distilled information for you to consider, depending on your age.

Every year, as you approach age 65 or if you are beyond that age, you start getting bombarded with ads about Medicare enrollment starting in August.  If you are like most people, you probably stop paying attention after the first few years.  That might not be in your best interest.  Here is some distilled information for you to consider, depending on your age.

Age 64

You will become eligible for Medicare in the next 12 months.

1.  Three months prior to the first day of the month in which you turn 65, is when you should apply. It can take that long, and you need receive your Medicare number before you can apply for supplemental insurance and drug coverage. See our infographic to help you understand Medicare parts and coverage. Coverage can begin on the first day of your birth month. Initial enrollment is done through Social Security.
2.  Then you choose a supplemental option: either Medicare Advantage or a Medicare Plan (F-Z), to cover the 20% that Medicare A/B does not cover. See below for ways to enroll.
3.  Then you add a drug plan, if you did not choose Medicare Advantage. Penalties apply if you wait to do this later. See below.
4.  Optionally, you can add dental, hearing, vision, and catastrophic insurance.

Age 65+

Open enrollment/change is from October 15th to December 7th each year. This is when you can make a change to your supplemental, drug, and other coverages. (You can also switch between Medicare Advantage and a supplemental plan BUT there may be a waiting period of 6 months or more, and/or a health screening to pass.)

Changing supplemental plans may also require a waiting period or health screening, but not always. So this is a way to potentially improve coverage or save money.

Re-evaluating your drug plan annually makes the most sense, especially if you have high-cost prescriptions or have new prescriptions. Unfortunately, doing so requires some dedicated, tedious homework.

•  The same drug can be priced in a different ‘tier’ by different drug plans. Higher tiers have higher co-pays.
•  A pharmacy can be preferred for one drug, but not for another.
•  Plans have different preferred pharmacies

In the end, you have to try to find a plan where most of your medications are available at the same preferred pharmacy. Medicare has an online search engine that helps you evaluate plans but I have found it to be somewhat buggy. If you know a better one, let me know and I will share it. eHealthMedicare.com (an online broker site) helps to a point but doesn’t choose the best pharmacy to use without some effort.

If you have used the same drug plan for a number of years, chances are that you can save by looking for a new one.

Anyone age 64 or older: Help Choosing

If you are looking for Medicare related insurance, either supplemental or a drug plan, there are both government agencies and private brokers who specialize in helping you select the best plan based on your situation.

Government offices for mid-Atlantic states are shown on our infographic mentioned above or you can find your state’s office here. They are often known as SHIP (State Health Insurance Assistance Programs) and can be very helpful.

Private broker firms are paid by the company you enroll with, like a commission, and so there is no cost to you. Their pricing will be the same as the government agency. Different brokerages/agents have different insurance areas they cover. Some may deal with drug plans, some with supplemental plans, and with other types of health insurance. Check them out through NAHU.org, the National Association of Health Underwriters.

I hope this helps you with knowing what you need to do and when you need to do it. Daily Money Managers often help clients with their Medicare options for those who find it too daunting. There are a lot of moving parts and the best tools are online!