It’s THAT time again. Open enrollment runs from October 15th through December 7th providing all Medicare beneficiaries and people in the individual marketplace an opportunity to review their health care coverage and decide whether or not they want to make changes for the upcoming year. Of course, if you’re happy with your plan there’s no need to do anything and you can just stay with what you have!
But make no mistake about it, this is the time to do a comprehensive assessment of your existing coverage and determine whether or not it is working for you. When doing an assessment most people focus primarily on their premiums but it’s important to think beyond price.
Take into account :
- What are your drug needs and are they covered under your Medicare drug plan’s formulary? (Go to www.medicare.gov to find your plan and then type in your list of drugs.)
- How is your plan rated? Yes, that’s right, the site will also give you with information on your plan’s customer service. Does your plan have five stars? Great decision – you rock!
- Has your health changed over the year and do you anticipate that you will need to see more doctors and / or take more prescription drugs? If that’s the case, are you in the best plan for your CURRENT situation?
- Do your doctors participate in Medicare? Do they participate in any of the Medicare Advantage Plans offered in your area? What plans and networks are they in? This important piece of information will help you to make some important decisions about which health care provider to see as well as which network you want to join.
The key thing to remember is that the plan you selected a year ago might not be the best plan for you right now.
And although the dates are somewhat different, the same holds true for individuals that went on the Healthcare Exchange. For coverage starting in 2015, the open enrollment period is November 15, 2014-February 15, 2015. Individuals may also qualify for special enrollment periods outside of open enrollment if they experience certain events.
These life events involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage. Job-based plans must provide a special enrollment period of 30 days.
At the end of the day and regardless if you are on Medicare or you’re an individual in the Healthcare Exchange, you should make your selection very carefully. Remember that if you are under 65 you must examine the available networks and see in which ones your doctor participates. If you are on Medicare, you have two options to consider, Medicare Part A and B and a Medicare Supplement Plan that can help defray some of the medical expenses not covered by Medicare A & B.
And yes, it certainly can be complicated. Please reach out to me if I can be assistance in helping you to maneuver through the myriad of health care options that are out there for you.
