Medicare open enrollment an opportunity to review

By Linda F. Fitzgerald

For those of us with Medicare, the fall season means more than enjoying the foliage, watching our favorite football team (for me, the New England Patriots) or preparing for the Thanksgiving holiday. It is also the season for Medicare open enrollment, which officially began Oct. 15 and runs through Dec. 7.

Like our other seasonal favorites, this is the only time of the year when the nearly one million Medicare beneficiaries in Massachusetts may review and make changes to their Medicare coverage. Any changes that you make will go into effect on January 1, 2013.

During open enrollment, you may:

•Switch to a Medicare Advantage plan;

•Switch from one Medicare Advantage plan to another;

•Drop your Medicare Advantage plan and return to Original Medicare; or

•Join a Medicare prescription drug plan, change to a new one, or drop your coverage.

Even if you are content with your current coverage, it is always a good idea to review your plan to make sure you are getting the most out of your Medicare. And, evaluating your plan options may be easier than you may think. Just follow the four “C’s”: coverage, cost, convenience and customer satisfaction.

Coverage: Comparing Medicare plans can be simple. The official Medicare website has a tool at www.Medicare.gov/find-a-plan that helps you find and compare all of the plans available in your area. When reviewing plans, focus on the benefits, such as the coverage offered while you are in the prescription drug doughnut hole, the period during which you pay a higher share of your drug costs. Also, find out which drugs are covered.

If you need help comparing coverage options, you may work with SHINE (Serving the Health Information Needs of Elders) counselors for free assistance. Be sure to ask the counselor questions that matter to you, such as whether you will have coverage if you get sick while traveling out of state. Call your local senior center or council on aging to make an appointment with a SHINE counselor.

Cost: From year to year, your Medicare plan costs may change. During open enrollment, you should compare all of the costs, including premiums, deductibles, drug costs and out-of-pocket maximums.

Convenience: When it comes to going to doctor’s appointments and filling prescriptions, we know convenience matters. When reviewing Medicare plans, find out if you will have access to your doctor, or doctors nearby. And, check that your local pharmacy accepts the plan, and that the plan provides online prescription-filling or mail-order options.

Customer service: Have you ever wondered how your Medicare plan stacks up against others? When you are comparing plans, take note of Medicare’s star-rating system. Medicare health and prescription drug plans are rated on how they perform in different categories, such as responsiveness and care, member complaints and customer service. A plan may rate between one star (poor) and five stars (excellent).

After you’ve gone through the four C’s, it’s time for the D — decide. Remember, even if you are happy with your Medicare plan, it is wise to evaluate your options since the open enrollment period is the one and only time each year when you may switch plans. Once you complete the four C’s of comparing coverage, cost, convenience and customer service, you will be poised to make a well-researched decision to either change your plan or stay with the one you have.

Keep in mind: it’s important to review your options carefully. In some cases, if you drop your coverage, you may not be able to get it back. Also, during this sole season of Medicare open enrollment, if you miss the December deadline, you will have to wait until next fall to switch to a different Medicare plan.

For more information about Medicare open enrollment, visit www.aarp.org/openenrollment or call 866-448-3621 and request the free Medicare open enrollment resources, Twelve Questions You Can Ask (D19576) and Eight Things You Can Do (D19575).