Helpful Tips for Medicare Open Enrollment

by Ricardo Marin, M.D. • JSA Medical Group • www.jsahealthcare.com


Medicare open enrollment, which occurs annually from Oct. 15 through Dec. 7, marks an important time of year for individuals older than age 65 to change their health plans and prescription drug coverage for the following year. Below are several tips to help seniors who are reviewing their health plans.

  • Review changes to health plans — Seniors have many details to keep in mind during this election period. There are often changes to Medicare health plans from year to year, which is why seniors should carefully review their plans to identify any modifications that might affect their access to care. Seniors should consider costs, benefits and health care provider choices available. They should also identify whether all of their necessary health care services and prescription medications are still covered under their current plans.
  • Know your enrollment period — It is important to distinguish Medicare open enrollment from other health-related enrollment periods. Some people might confuse Medicare open enrollment with the open enrollment period for the state and federal exchanges under the Affordable Care Act. These two are separate enrollment periods and are not associated with each other.
  • Consider Medicare Advantage — Open enrollment serves as a valuable opportunity for seniors to change their coverage plans. Many might want to explore Medicare Advantage plans, which may fit their health care needs. Medicare Advantage plans typically offer improved access to coordinated care. According to the Centers for Medicare & Medicaid Services, Medicare Advantage plans can also provide protection against high out-of-pocket expenses. Some of these plans also offer personalized telephone care management, health coaching, and education and support from health care professionals. These plans also serve as alternatives to Medicare Private Fee-For-Service plans.
  • Identify costs beyond premiums — Consider all of the costs associated with a plan, not just the monthly cost, also known as a premium. This includes assessing copays, coinsurance and deductibles to obtain a clear picture of how much will be spent on health care for the year.
  • Consider access to coordinated care — Thoroughly review coverage options to determine if it will provide access to coordinated care, a value-based form of health care in which a team of providers work in collaboration to promote preventative, high-quality care.
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