All of the Americans who receive their insurance benefits from Medicare need to become aware that the Medicare Open Enrollment Period will begin this coming October 15.

What is the Medicare open enrollment period?During this open enrollment period you can make new choices and pick plans that work best for you depending upon your doctors and the medications you are taking.   Each year Medicare plans change what they will cost and what they will cover. In addition, your health-care needs may have changed over the past year. This annual  open enrollment period is your opportunity to switch Medicare health and prescription drug plans to better suit your needs.What are the dates of the Open Enrollment Period?

The Medicare open enrollment period begins on October 15 and runs through December 7. Any changes made during open enrollment are effective as of January 1, 2014.

What can I do during this period?

  • Join a Medicare Prescription Drug Plan
  • Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan
  • Drop your Medicare prescription drug coverage altogether
  • Switch from Original Medicare to a Medicare Advantage Plan
  • Switch from a Medicare Advantage Plan to Original Medicare
  • Change from one Medicare Advantage Plan to a different Medicare Advantage Plan
  • Change from a Medicare Advantage Plan that offers prescription drug coverage to a Medicare Advantage Plan that doesn’t offer prescription drug coverage
  • Switch from a Medicare Advantage Plan that doesn’t offer prescription drug coverage to a Medicare Advantage Plan that does offer prescription drug coverage

What should you do?

These are a lot of decisions and often sorting through the information is confusing.  Even though there is still two weeks before the open enrollment period actually starts, now is a good time to review your current Medicare plan. Tin reviewing your current plan you may want to consider if  are you satisfied with the coverage and level of care you’re getting with your current plan? Are your premium costs or out-of-pocket expenses too high?

Has your health changed, or do you anticipate needing medical care or treatment? Now is the time to determine if your current plan will cover your treatment and what your potential out-of-pocket costs may be. If your current plan doesn’t meet your health-care needs or fit within your budget, you can switch to a plan that may work better for you.

There are some changes coming in 2014, what are they?

Most Medicare Prescription Drug Plans have a temporary limit on what a particular plan will cover for prescription drugs. In 2014, this gap in coverage (also called the “donut hole”) begins after you and your drug plan have spent $2,850. It ends after you have spent $4,550 out-of-pocket, after which catastrophic coverage begins.

However, part of the Affordable Care Act (ACA) gradually closes this gap by reducing your out-of-pocket costs for prescriptions purchased within the coverage gap. In 2014, you’ll pay 47.5% of the cost for brand-name drugs in the coverage gap and 72% of the cost for generic drugs in the coverage gap. Each succeeding year, out-of-pocket prescription drug costs within the coverage gap continue to decrease until 2020, when you’ll pay 25% for covered brand-name and generic drugs within the gap.

Health Exchanges (Marketplaces), what is their role for Medicare Recepients?

Health Exchanges, or Marketplaces, which are part of the ACA, are available for people to shop for health insurance coverage. The Exchanges are scheduled to open October 1, 2013. The ACA also includes an insurance mandate, which requires most individuals to have health insurance or face a penalty. However, if you have Medicare, neither provision applies to you. As a Medicare recipient, you won’t face penalties for being uninsured. Also, Exchanges do not provide information on Medicare plans, and you can’t purchase Medicare coverage through an Exchange.

Where can you get more information?

Determining what coverage you have now and comparing it to other Medicare plans can be confusing and complicated. Pay attention to notices you receive from Medicare and from your plan, and take advantage of help available by calling 1-800-MEDICARE or by visiting the Medicare website, www.medicare.gov. Your financial professional  and your druggist can also help you find the information you need to make decisions about Medicare.

Joel T Nowak, M.A., M.S.W.