Medicare Open Enrollment Period: Navigating the Choices

August 23, 2016

Did you know that you don’t have to live with the same Medicare Plan that you started with?

Every year, during Medicare’s Annual Enrollment Period (AEP), you can change plans, add or change prescription drug coverage or move to an Advantage Plan offering.

This year, the 2021Annual Enrollment Period is from October 15, 2020, to December 7, 2020.

Now’s the time to start thinking about your current coverage, how it’s performing, whether or not it continues to meet your personal and healthcare needs, or if it’s still affordable.

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Here’s how to navigate your options

Start at the beginning

You’ll need to decide if you want to maintain Original Medicare, Supplemental Plan, and separate Prescription Drug (PDP) coverage or if you want a Medicare Advantage Plan with Prescription Drug (MA-PD).

Here’s how the two options break down.

Original Medicare

Original Medicare includes both hospital and medical insurance (under Part A and Part B).

An overview

This is what you need to know about Original Medicare:

  • Original Medicare Parts A and B cover much of the medical care you may need, but not all of it.
  • You’ll have to pay deductibles and coinsurance yourself unless you have supplemental plan coverage.
  • You can choose to use any doctor or hospital that accepts Medicare.
  • There’s usually a monthly premium that goes along with Part B coverage.

Supplemental Plans

There are lots of gaps in the coverage provided by the Original Medicare Parts A and B. A supplemental plan is designed to fill them in.

These policies are also called Medigap or MedSup and are standardized plans designs delivered by private insurance companies approved by Medicare.

Supplemental policies provide the most comprehensive coverage, access to doctors and hospitals and is the most popular coverage approach taken by people turning 65 or who want to have fewer or no out-of-pocket expenses. However, supplemental plans are more expensive and monthly premium rates increase annually with age.

Prescription Drug Plans (PDP) or Part D

Because neither Original Medicare or supplemental plans provide coverage for outpatient prescription drugs, it’s important to obtain or maintain this coverage.

A person’s health and required medical care can change year to year, along with the prescriptions they take. It is important to reevaluate your Part D coverage and medication list during the Annual Enrollment Period to make sure your coverage continues to meet your specific needs.

Your Part D Plan monthly premium, your out-of-pocket cost and the list of prescription drugs covered under your plan formulary are also subject to change. The AEP provides you the opportunity to change to a plan that you can afford.

Medicare Advantage

An overview

If you’re interested in Medicare Advantage (MA), or Part C, this is what you need to know about this option:

  • You get all the benefits of Original Medicare Parts A and B.
  • Plan options are provided by private insurance companies that Medicare has approved.
  • Plans are designed as HMO’s or PPO’s and require the use of network doctors, specialists, and hospitals.
  • You will pay a low monthly premium to the plan. Zero-premium plans may be available.
  • You will continue to pay Part B premium as well as plan coinsurance, copayments or deductible.
  • Extra benefits may be available like Prescription Drug, Vision care or Dental exams.

Not all Medicare Advantage Plans include prescription drug coverage. Advantage Plans that include coverage for prescription drugs are known as MA-PD Plans

Keep in mind, however, that if you have a Medicare Supplemental Plan and want to change to a different plan or you have a Medicare Advantage Plan (MA-PD) and choose to return to Original Medicare during the Open Enrollment Period, you may be required to complete a medical health questionnaire to determine if you are eligible to enroll or re-enroll in a Supplemental Plan. If approved, you may need to apply for Part D (PDP) to cover your outpatient prescription drugs.

Get started

Confused about your options? Talk to a Medicare Plan Specialist at UROne Benefits™ before the Medicare Annual Enrollment Period begins.

We’ll be happy to walk you through your options and demystify the complicated process of buying or changing your Medicare coverage.



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