Go Shopping: A Guide to Open Enrollment [Part 3]

October 19, 2017

by: The My Medicare Matters Team

This article is the third installment in our 2018 “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 first OEP blog post: “Watch Your Mailbox: Preparing for Open Enrollment [Part One] »

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

Read the fourth OEP blog post: “Seek Expert Advice: A Guide to Open Enrollment [Part Four] »

Maybe you’ve heard the saying, “the grass isn’t always greener on the other side”? When it comes to Medicare plans, the grass might actually be brighter and greener on the other side! In fact, there’s proof. Studies show that on average, Medicare beneficiaries could save $300 a year just by switching to the lowest cost Part D plan that covers their medications.

And it all starts with remembering to use the Medicare Open Enrollment Period to check out other plan options that might be available to you. The Open Enrollment Period (OEP) occurs every year from October 15th to December 7th. During OEP, anyone with Medicare can change their prescription drug plan or Medicare Advantage plan for any reason.

To start, approach it like any other major purchase. For example, think about the steps you take when buying a car. You’re likely to test drive cars, compare features, review gas mileage, consider repair costs, and read  reviews of the car. Shopping for a Medicare plan isn’t all that different. Learn more with our 5 step guide below:

  1. Start with your Annual Notice of Change (ANOC) homework, outlined in our recent blog post, to compare your plan this year with its coverage in 2017. Then, compare it among many other options to see if the grass really is greener. In some states there are as few as 18 plans and others as many as 25 plans just to cover prescription drugs. Additionally, in some states there are as few as zero Medicare Advantage plans and others as many as 15 plans. So, how can you know if there is better plan than what you have now?
  2. Avoid the common mistake of choosing a plan based solely on the premium and deductible. You wouldn’t buy a car based on the monthly payment alone, so don’t do this with your Medicare plan either. Use the Medicare Plan Finder at www.medicare.gov by clicking on the ‘Find Drug and Health Plans’ button or tab. Be sure to watch the video tutorials on the right-hand side of the screen to learn how to use the website.
  3. Gather up your Medicare card and any bottles for prescriptions you currently take–your costs will vary based on the strength of your medications and how often you take them. Select the ‘personalized search’ option, enter your Medicare number, your drugs, and  select your pharmacy (pick a second pharmacy to compare too). When you reach the plan summary page outlining all the plans available to you, look first at the “annual estimated cost” because it includes ALL out-of-pocket costs like the premium, deductible, and what you pay the pharmacy for your medication. You can compare three plans at a time so be sure to select your current plan and two others to compare.
  4. In addition to the cost, look at the “drug coverage information” section near the bottom of the screen. This is the section that details whether all your drugs are on the plan formulary and whether the plan will restrict access to the medications you need. The restrictions could include quantity limits on the number of pills per month, prior authorization from your provider, or step therapy (which requires you take another medication for up to 90 days before the insurance company considers paying for your usual medication). Restrictions aren’t necessarily a deal breaker, but you need to make sure you’re comfortable with them if they apply.
  5. Using these shopping tips, narrow your choices down to two or three plans. Print out or write down the details of the plans and think about it for a few days. Make a list of any questions you have, and then try taking our Medicare Questionnaire assessment, which can connect you to free professional advice about Medicare from a licensed benefits advisor. Or call your local SHIP (State Health Insurance Assistance Program) to access federally-funded Medicare counseling.

Remember, most beneficiaries have until Dec. 7th to make changes, unless you were affected by Hurricanes Harvey, Irma, and Maria then you qualify for a Special Enrollment Period (SEP) through the end of the calendar year. Fall is a busy time–so start shopping soon! 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.