It's time for Medicare Open Enrollment! How can I help my care receiver?

Posted: October 7, 2015, 3:57PM

Well, here we are! Once again, it's that time of year when Medicare beneficiaries can change their Part D (prescription drug) product, enroll in or change a Medicare Advantage Plan, or change Medicare Supplement plans.

Lots of choices! Too much information or not enough information? Where do you start? Be aware that the product you have for 2015 may not be available in 2016, the coverage may have changed, and/or the price may have changed. There are several changes with the 2016 products. For example, Cigna HealthSpring Rx Secure-Max will not be available in 2016 and beneficiaries will be switched to Cigna HealthSpring Secure-Extra if they don't change during Open Enrollment. There is a significant price increase with this change and also an added $250 deductible.

But - to get started: You or your care receiver should have received a notice from their existing company about the 2016 product. Take out the Annual Notice of Change and look at the first few pages. Major changes should be noted.

Is the premium going up? (Rule of thumb: if the increase is 10% or higher, there may be a better option for you) What about the deductible? Were there changes? If this product had a zero deductible and now it's not - look around.

OK - Now, look at the drug changes. This is more challenging! Did the company add a tier? Does that affect generics? Does it affect other drugs that the care receiver uses? Have drugs been removed from the forumlary? Have drugs changed tiers?

Does the care receiver have a Part C / Medicare Advantage / Managed Care plan? What will the copays be in 2016 compared to 2015? Were there unexpected medical expenses that the plan did not cover? Do you need to look at a Medicare Supplement and Part D product as stand-alones?

You need to evaluate plans and products EVERY YEAR. Look at premiums (changes?), coverage (changes?), deductibles (changes?), your medical needs and explore your options.

There is help out there!

You can go to the Medicare home page where you will learn about Medicare coverage as well as the components of Medicare. There is a Plan Finder section where you can fill in your care receiver's drugs and do some comparison shopping of products.

You can talk to your State Health Insurance Information Program (SHIP) counselor. SHIPs provide free Medicare counseling. You can also call 1 877 839-2675.

You can call 1 800 MEDICARE (1 800 633-4227).

Contact us at Altenheim Resource Services. OR - go to the Events & Programs section of our website! We have some informational programs scheduled to help consumers.