Watch Your Mailbox: A Guide to Open Enrollment [Part 1]

September 23, 2016

Pile-of-mail-FINAL

by: The My Medicare Matters Team

This article is the first installment in our 2016 “Preparing for Open Enrollment” series. To stay up-to-date on the latest Open Enrollment blog posts, subscribe to our mailing list. For a complete overview of Open Enrollment, check out our “Guide to Open Enrollment” page.

Read the second OEP blog post: “Gather Your Things: Preparing for Open Enrollment [Part Two] »

Read the third OEP blog post: “Go Shopping: Preparing for Open Enrollment [Part Three] »

It’s finally fall! For many people, that means football, foliage, and delicious pumpkin-flavored treats. For Medicare recipients, fall also signals a slightly-less-fun (but equally important) event: the annual Medicare Open Enrollment Period (OEP). Open Enrollment occurs every year from October 15th to December 7th. During Open Enrollment, anyone with Medicare can change their prescription drug plan or Medicare Advantage plan for any reason.

You may be thinking, “But I already chose my Medicare plan! Why change plans and go through all that again?” The answer is simple: to make sure your coverage is still the best fit for your needs. Insurance companies can make yearly adjustments to Medicare plans, potentially increasing your out-of-pocket costs (these changes are outlined in your Annual Notice of Change–more on this below). Given these yearly changes, it is a good idea to re-evaluate your current Medicare plan each year, and compare it against other available options. Switching to a different Medicare Advantage or Part D plan could potentially save you hundreds of dollars a year.

Not sure where to start? Check your mailbox

Not sure where to start when it comes to evaluating your coverage? It’s actually as easy as looking in your mailbox. Starting in October, insurance companies will start flooding your mailbox with marketing materials about their plans. The Centers for Medicare and Medicaid Services (CMS) will also send you mail alerting you to coverage changes you may need to make. So, how do you know which mail to open and which to recycle?

To start, follow our guide to the most important mailers below:

  • Annual Notice of Change/Evidence of Coverage (ANOC/EOC): You’ll receive this if you have a Medicare Advantage plan or a Medicare Part D plan. Your plan has to mail it out to you by September 30, so it should be in your mailbox in early October. If you don’t receive it by the second week in October, then call your plan and ask for it. Or look for it online and download a copy. The ANOC/EOC is a BIG packet (it’s easy to get overwhelmed) but resist the urge to stash it in a drawer unopened. You will need the Evidence of Coverage (EOC) part because it lists specific details about when your plan will cover costs, which you will need if you have to file an appeal. The ANOC part lets you know what aspects of your plan will change from 2016 to 2017; remember, insurance companies can make yearly changes to Medicare plans that might increase your out-of-pocket costs. The ANOC/EOC is the only mailer plans are required  to send out in order to alert you to these yearly plan changes. Whether the changes are major or minor, you need to figure out what impact they will have on you.
  • Medicare & You Handbook: The Centers for Medicare and Medicaid Services (CMS) mails this handbook out in late September. If you don’t receive one by the second week in October, call 1-800-Medicare to get another copy with your state’s specific plan information, or go to medicare.gov to view the general information online. This handbook contains lots of useful information about when Medicare covers certain services, including preventive care, medical equipment and supplies, and much more.
  • Additional mail from the Centers for Medicare and Social Security:
    • If your current plan will no longer be available in 2017, CMS will mail you a letter saying you need to pick a new plan. In addition, your insurance company might send you a letter offering to move you into a different plan to replace the old one. No matter what you decide, make sure you enroll in your new plan by the end of the Open Enrollment period (Dec. 7).
    • CMS will also send you a letter if your current plan received a low star rating for at least three years in a row. Plans with a 5-star rating are considered high quality, and those with fewer than 3 stars are considered poor quality. If your current plan is ranked as less than a 3, consider using the Open Enrollment period to switch to a higher rated plan.
    • Do you qualify for Extra Help to help pay some of the costs of your Part D prescription drug plan? You may receive a letter from CMS saying that you’ll be put in a different plan in 2017; this is known as “reassignment.” Additionally, some people with Extra Help receive letters because they need to submit income information to stay in the program; this is known as “redetermination”.
  • Going paperless. If all this paper mail becomes overwhelming, you can take steps to go paperless. Create a Medicare.gov account to start receiving all notices via email. Then, call your plan to learn about their paperless options. You can find their customer service phone number on your insurance card.

Still confused about Open Enrollment? Try taking our Medicare Questionnaire assessment, which can connect you to free professional advice about Medicare from a licensed benefits advisor. And check back on this blog for the next couple months for more Open Enrollment guides and tips, or subscribe to our mailing list and we’ll send the tips right to your inbox.

No matter how busy your fall gets, be sure and make a little time to review the mailings listed above. It can make a huge difference to both your bottom line and the quality of your care.