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Fall Medicare Open Enrollment will be here before you know it. At that time you can change your Medicare coverage for the coming year to better meet your needs. You can do this by joining a new Medicare Advantage Plan or by joining a new stand-alone prescription drug plan (PDP). You can also switch to Original Medicare with or without a stand-alone Part D plan from a Medicare Advantage Plan during this time, but a penalty may apply.

Here are the six things to keep in mind while you are deciding on your Medicare coverage this year.

  1. 1. Fall Medicare Open Enrollment Occurs from October 15 to December 7 of Each Year.

  • – If you enroll in a plan during Fall Open Enrollment, your coverage starts January 1.
  • – In most cases, Fall Open Enrollment is the only time you can pick a new Medicare Advantage or Part D plan.
  • – If you have Medicare Advantage, you can also switch to Original Medicare. To get drug coverage, you must join a stand-alone Part D plan at this time. A Medigap policy helps pay Original Medicare costs, but you may be limited in your ability to buy Medigap during the Fall Open Enrollment Period, depending on where you live and your health condition.
  1. 2. Review Your Current Medicare Health and Drug Coverage. 

  • – If you have Original Medicare, take a look at next year’s Medicare & You” handbook to know your costs and benefits for the upcoming year. If you are unsatisfied with your Original Medicare coverage, you can make changes to your coverage during Fall Open Enrollment. Changes made to your coverage will take effect January 1 of the next year.
  • – If you have a Medicare Advantage or a stand-alone Part D plan, you should receive an Annual Notice of Change (ANOC)and/or Evidence of Coverage (EOC). Review these notices for any changes in the plan’s costs, benefits, and/or rules for the upcoming year. If you are dissatisfied with any upcoming changes, you can make changes to your coverage during Fall Medicare Open Enrollment.
  • – Even if you are satisfied with your current coverage, take action and look at other options in your area. There maybe a plan that better suit your individual needs in the upcoming year. For example, even if you are satisfied with your current Advantage or Part D plan, you should check to see if there is another plan in your area that will offer you better health and/or drug coverage at a more affordable price. Research shows that people with Medicare prescription drug coverage (Part D) could lower their costs by shopping among plans each year.
  1. 3. How to Find the Right Plan. 

  • – If you want to join a stand-alone prescription drug plan (PDP), use the Plan Finder tool. This tool compares plans based on the drugs you need, the pharmacy you visit, and your drug costs.
  • – If you want to join an Advantage Plan, call 1-800-MEDICARE to find out what plans are in your area. When you receive the list of plans, check the plans’ websites to see which best fits your needs.
  • – After you have researched a plan online, call the plan itself to confirm what you learned. Confirm that the plan covers all your drugs, and that your pharmacies, doctors and hospitals are in the preferred network. Write down everything about that conversation, including the date of the conversation, who you spoke with, and the outcome of the call. This information may help protect you in case a plan representative gives you misinformation.
  1. 4. The Best Way to enroll in a New Plan is to Call an Agent. 

  • – Enrolling in a new plan directly is the best way to protect you if there are problems with enrollment.
  • – Before you enroll, confirm all of the details about your new plan with the plan itself.
  1. 5. If you are dissatisfied with your Medicare Advantage Plan, you can dis-enroll from the plan and join Original Medicare during the Medicare Advantage Disenrollment Period (MADP). 

  • – The MADP is every year from January 1 to February 14.
  1. 6. Understand the difference between the Fall Medicare Open Enrollment and Open Enrollment for the Health Insurance Marketplaces.

  • – The Health Insurance Marketplaces (also known as Exchanges) offer annual open enrollment periods for uninsured and underinsured Americans. This enrollment period may overlap with Fall Open Enrollment. The Marketplaces are not meant for people with or those eligible for Medicare.
  • – If you have or are eligible, you should only use the Fall Open Enrollment Period (October 15 to December 7) to make changes to your coverage.

Just call us at 724-929-2300 today. Our experienced and trained staffs can help you understand your options and get you the right Medicare coverage to fit your needs! If you are nearing age 65, the Medicare Open Enrollment period can be confusing, but we are here to help.