The Open Enrollment Period for Medicare Advantage plans will be ending on December 7, 2012 for a January 1, 2013 effective date.
- If you are currently enrolled in a Medicare Advantage plan and you are pleased with the premium and benefits and your physicians will continue to accept your plan, you do not need to do anything. The plan will roll over for the year 2013.
- However, if you want to look at other plans or your physician has decided not to accept your plan, you need to take action quickly.
- And, if you are considering purchasing your first Medicare Advantage plan, the December 7 cutoff date will most likely apply to you as well.
- Review your existing Medicare Advantage coverage – you should have received an Annual Notice of Change letter in the mail from your insurance company. Study this letter or the Summary of Benefits for the 2013 plan to make certain you are comfortable with the benefits and premium.
- Make a list of your prescription drugs and check them against your plan’s formulary. Often you will find the formulary has made changes and you want to make certain your prescriptions are still covered to your satisfaction.
- Check with your physicians. They sometimes make changes in the plans they will accept. Unless you are willing to change doctors, you will need to make sure your insurance choice is also one your doctors take.
- Pay attention to copays and out-of-pocket expenses. Also, the maximum out-of-pocket the plan states is an important factor. This maximum could have a significant impact on your wallet should the worst happen and a major illness occurs.
- Think about added benefits that would be most important to you. Medicare Advantage plans usually offer added benefits like vision care or hearing assistance or alternative medicine. The added benefits may help you make a decision if you are on the fence between a couple of plans.
- Look at the plan’s quality rating established by Medicare. Plans are rated from one star being poor to five stars being excellent. At this point in time, there are only 15 five-star rated plans in the country so you may have to settle for four or even three stars. Anything less than three stars and you will receive a letter from Medicare asking you if you are certain about your decision. The star ratings are shown on www.Medicare.gov.
What happens if you miss the December 7 deadline?
- If you are already on a Medicare Advantage plan, your plan will roll over for another year.
- If you are on a Medicare Advantage plan that is leaving the market and you take no action, you will automatically return to Original Medicare. Since Original Medicare does not offer Prescription Drug coverage, you will be without this important benefit. You will have an extended Special Election Period that may run through the end of February 2013 where you can purchase a different Medicare Advantage plan but you must realize, you will not have full protection and drug coverage if you put off your decision past the end of 2012.
If you need help looking at your options, there are places to get help:
VibrantUSA specializes in Medicare insurance. Contact them at 866-733-5111 or visit their website at www.vibrantusa.com.
If you are web savvy, www.Medicare.gov is a good source of information.