Medicare Open Enrollment 2016 (Update)
“Medicare Open Enrollment” is the thing today. There are several commercials and mailers on the topic. My friends in England knows that it’s that time of year. But what does that mean for you, really? How does the period help or hurt you? How can you be prepared? Hopefully, this information will prove valuable to you.
What is Open Enrollment
Open enrollment is a period of time between October 15th and December 7th every year that you can freely enroll in different specific parts of Medicare. Keep in mind that it is only specific parts (which is where people tend to get confused), but mainly Part C and Part D. I advise that you check on your Part D plan, as you can change to any plan that you would like. Sometimes, you end up being in a better position by switching plans based on your changed medications. You do NOT have to be in the same prescription plan the rest of your life–your only dating your plan, not marrying it.
You can also do the following during Open Enrollment:
- Switch from Original Medicare to Medicare Advantage
- Switch back to Original Medicare FROM Medicare Advantage
- Note that Enrolling into a Part D plan while enrolled in a Medicare Advantage plan will disenroll you from Medicare Advantage.
- Switch from Medicare Advantage to Medicare Advantage
- Or keep the same plan.
These changes go into effect January 1st of 2016. Do realize that there is a huge difference between Medicare Supplements and Medicare Advantage? They are two completely different concepts that you cannot have at the same time. Which one works for you?
What is Open Enrollment NOT for
Medicare Open Enrollment is NOT for Medicare Supplements. Hopefully, you have already carefully selected your Medicare supplement so that it will be the right plan for you for the rest of your life (you marry your Medicare supplement, you don’t date it). There is no one plan that fits everyone. The good news is that you can research your company’s rate increase history, its rate structure, and its satisfaction rating and switch to any Medicare supplement at any time of the year, as long as you medically qualify. Even in situations where you don’t think you will qualify for a plan, it is a good to try and reach out to companies if you are looking to switch your Medicare Supplement. I know of one particular company that has a simplified underwriting period that is available to seniors between the ages of 65 and 69. Of course, you can go to a Medicare Supplement without any medical questions in certain situations, like if you are over 65 and just leaving the workforce and your group insurance plan.
What you need to do for Open Enrollment
There are a few different things you can do during this period. I would follow these in order depending on your situation.
- If you are wanting to leave your Medicare Advantage plan, contact Medicare Supplement Agent.
- He or she can assist you in disenrolling from your plan to where you don’t have to worry. They can make sure that everything is disenrolled in a proper fashion so that you don’t have any gaps in health coverage.
- Reach out to an agent like myself even if you don’t think that you will qualify. I have qualified a man that had just had a heart attack. So it is possible.
- Contact your Medicare Advantage agent if you want to stay in your Medicare Advantage plan.
- He or she can make sure you are in the right plan based on your medical and medication needs.
- If you like the company, you will be able to move smoothly into another plan through that agent.
- Networks and deductibles are changing each year, so what works next year may be completely different from what is working for you now.
- Shop around for other Medicare Advantage plans
- If you are unhappy with the company you have been with for the past year, you can change to any companyDeductibles and networks are changing, so what worked for you this year may or may not be the best fit next year.
- Deductibles and networks are changing, so what worked for you this year may or may not be the best fit next year.
- Go to Medicare.gov and enroll in a Part D Plan if you want to go back to Original Medicare without a supplement.
- Enrolling in a Part D plan will disenroll you from a Medicare Advantage plan.
- Make sure you have your complete list of prescriptions with you so that you can get the best estimates in prices
- You can contact an agent that can help you with Part D, but going to medicare.gov first will help give you an idea.
- Just leave everything alone.
- If you are happy with where you are and your plan will work for you next year with changes in your ANOC (Annual Notice of Change) if you are on Medicare Advantage, then you have nothing else to do.
- If you are happy with your Medicare Supplement company and its rate increases (or lack thereof), then you also have nothing to do.
What is Changing In Medicare In 2017
There are some good things and some things that many may not like about the face of Medicare for 2016. Some changes will go into effect immediately while others are changes we will see down the road. Here are some key points for next year’s Medicare changes:
- There are still helpful agents to help with the bad!
- Some Medicare beneficiaries will see yet another premium increase this year for Part B (this is to be expected)
- If you get Medicare Part B premiums deducted from your Social Security check and there is no cost of living increase, you won’t see this change.
- If you don’t meet any of the above requirements, you could see an increase of 52% or more. Brace yourselves.
- The “Doc Fix” law has been signed. In 2020, there can be no new Medicare Supplements sold that cover part B deductibles.
- Don’t worry, though, because your current plan C or F will be “grandfathered.”
- Just know that if you are planning on making changes to either of those plans in 2020, you will not be able to.
- In 2018, if your income is more than $133,500 ($267,000 for couples), you will pay higher premiums
Part D Changes
- The donut hole (prescription coverage gap) is shrinking! That means more donut and less hole.
- 2016 starts at $3,310. Next year it will start at $3,700
- This means you have to spend more before your lower benefit amount kicks in
- Your Part D coverage will be more meaningful throughout the year.
- Catastrophic coverage 2016 starts at $4,850. Next year, it will start at $4,950
- 2016 starts at $3,310. Next year it will start at $3,700
- The amount of coverage during the donut hole is more favorable
- 2016, currently pay 45% of brand-name drug costs and 65% of generics until you reach the other side of the hole
- 2017, pay 40% of brand-name drug cost, but only 50% of generic drugs!
- Premiums remain an average of $32.50 per month
Ack! Well, there’s always a bad side to change. Hopefully the good outweighs the bad in your situation.
- Initial deductible has been increased on the base plan from $360 to $400
- Minimum cost-sharing during catastrophic coverage will be $3.30 or 5% (whichever is higher) for preferred or generic (up from $2.95)
- Minimum cost-sharing (catastrophic) will be $8.25 or 5% (whichever is higher) for all other drugs (up from $7.40)
I found a great chart that highlights all the changes through the past few years here.
Another scary idea is that Medicare Advantage members are expected to pay more for a week in the hospital in a certain case than Original Medicare alone. One source states that they are expected to pay over 60% more for a week in the hospital and 20 days in a skilled nursing facility then someone on Original Medicare without a supplement (*source: “Why Are Medicare Advantage Co-Pays So High?” By David Orenstein-Brown (Brown University). This scares me. People enroll in a Medicare Advantage plan in order to save money. This may not always be the case. However, these statements cover a wide range of companies and may not be true for the plan you have chosen. Just do your homework!
I tell you all these things for this purpose:
Look at your plan and make sure it’s going to work for you next year. It may have been perfect “THIS YEAR.” But these plans are changing drastically in some cases. Open enrollment is only a couple months long. Please do your homework and reach out to appropriate people.
Please, leave a comment below if you have any questions about any of this. This is a very brief overview and there is a lot more information that you need to know. If you live in Indiana and would like a live consultation, email me at email@example.com. I am a licensed agent in Indiana focused on education. Have a fantastic Open Enrollment!https://simpleseniorhealth.com/medicare-open-enrollment-2016-updateAbout MedicareGeneralMedicare Supplements“Medicare Open Enrollment” is the thing today. There are several commercials and mailers on the topic. My friends in England knows that it's that time of year. But what does that mean for you, really? How does the period help or hurt you? How can you be prepared? Hopefully,...Raphael firstname.lastname@example.orgAdministratorRaphael resides north of Indianapolis, Indiana. He is an independent insurance agent. He is also the worship leader at his church, a husband, and step-father of one awesome 15-year-old girl. You can contact him at email@example.com.Simple Senior Health