Dear Toni:
“I turned 65 in Feb and did not enroll in a Part D, Prescription Drug plan. I’ve been told that I have to wait until Medicare’s Open Enrollment time to enroll in a Part D Prescription drug plan and even a Medicare Advantage plan. I thought I could enroll at any time of the year. Now I have to get some prescriptions covered. What can I do?
~ James…Memorial area
Hello James:
Medicare’s Open Enrollment involves only enrolling in a Part C Medicare Advantage plan and/or a standalone Part D Medicare Prescription Drug plan. * Open Enrollment does not involve changing or enrolling in a Medicare Supplement.* Open enrollment time period is only for Medicare Part C and Part D.
This year Medicare’s Open Enrollment starts on Tuesday, October 15, and it will end at midnight on Saturday, December 7th (Pearl Harbor Day). Making enrollment earlier helps the insurance companies and Medicare approve your application earlier and get your new insurance cards to you by January 1st. All plans will have January 1st as their start date.
This is the time when you can make changes to your Part D plan or Medicare Advantage plan or you can enroll if you missed your enrollment time when you were first eligible. Below are the changes that a Medicare beneficiary can make during OEP (open enrollment period):
- Enroll in a new Part D Medicare Prescription Drug Plan.
- Change from one Part D Medicare Prescription Drug Plan to a new Part D Medicare Prescription Drug Plan.
- Enroll in a Part C Medicare Advantage Plan with Prescription Drugs
- Change from one Part C Medicare Advantage Plan to a new Part C Medicare Advantage Plan.
- Return to Original Medicare and purchase a Medicare Supplement and enroll in a Part D Medicare Prescription Drug Plan.
- Return to Original Medicare only and enroll in a Part D Medicare Prescription Drug Plan
- Or Return to Original Medicare with no Part D plan.* Don’t forget there is a penalty for not enrolling in a Part D Medicare Prescription Drug plan when first eligible.*
For those who already have either a Part C Medicare Advantage plan with or without prescription drugs or a standalone Part D Medicare Prescription Drug plan, Medicare’s Open Enrollment is the time to make sure your drug plan or Medicare Advantage plan still meets your needs, especially if you had any changes to your health. Just visit Medicare’s website at www.medicare.gov and click on health & drug plans. There is a tool for helping you narrow your search for new Medicare health/prescription drug plans. There you can check factors like deductibles, co pays, co insurance and also premiums. You can compare up to three (3) plans at a time. With changes due to Healthcare Reform, it is wise to make sure every year that your prescription drugs are covered on your Part D Medicare Prescription Drug plan, even if you get your prescriptions from a Medicare Advantage plan. Plans may change their prescription drug formulary each year and if your prescriptions are not covered the next year, you may have to pay 100% of that prescription out of your pocket if it is not covered on your Part D plan.
Also…call your doctor or health care professionals and be sure he/she is still accepting whatever Medicare Advantage plan you are currently on or thinking of enrolling in.
Confused about Medicare??…attend one of Toni’s Medicare workshops. They are around the Houston Metro area or visit www.tonisays.com and purchase the Confused about Medicare DVD if you cannot get to a workshop or do not live in the Houston, TX area. The DVD is Ton’s workshop with all of the charts that she uses when she discusses Medicare and all of its Parts such as Part A, B, C and D, especially the difference in a Medicare supplement or (Part C) Medicare Advantage plan, what is Original Medicare and most importantly what is the “donut hole” and how can you keep from not jumping into it or getting in it so quickly.
Toni King is advocate/consultant for those “Confused about Medicare” send Toni an email at toni@tonisays.com or call 832/519-TONI (8664). Visit Toni’s facebook page and “like” it https://www.facebook.com/ToniKingSays
