By Amanda Haberlein,
Public Relations/Communications Coordinator for the Area Agency on Aging of Western Michigan
Each year Medicare offers an Open Enrollment period for those who have a Medicare Part D prescription drug program. Open Enrollment begins Oct. 15 and lasts through Dec. 7 and is the time when Medicare beneficiaries are encouraged to review their current plan and determine if it is still the best option to fit their current needs. This is the only time during the year that beneficiaries can make changes to their prescription coverage so it’s important that they review all the factors when making their decision.
In fact, the Michigan Medicare/Medicaid Assistance Program (MMAP) which utilizes volunteers to help people make informed health care decisions, including choosing a prescription coverage plan, recommends people follow the five steps below during Open Enrollment.
Five Steps to Choosing the Best Medicare Part D Prescription Coverage:
Review your current plan. Experts recommend that everyone reviews their current plan, even if you are happy with the coverage you have received. Plan information can change each year resulting in changes to medications that are covered, premium prices and even the co-pay amounts. Just because your current plan has met your needs, doesn’t mean it will continue to for the next year. Make note of any changes you see in your current plan and if they don’t work for you be sure to look at the other options available. If you are still happy with your current plan after you’ve reviewed any updates, simply do nothing and you will remain enrolled in the same plan.
Consider ALL your medications. It’s not uncommon to be prescribed a medication that you weren’t taking at this same time last year. Be sure to have a current list of all the medications you are taking and check each one against the plan you are considering to see if it’s covered and what the cost will be. Don’t assume that just because it is a low cost medication or well known drug that it will be covered in all plans. A simple way to start is to visit www.medicare.gov and input all your medications. They will then generate a list of plans that will cover those prescriptions. Again, you need to review those plans for things such as premiums, co-pays and coverage amounts before making a final decision.
See if you qualify for help. Experts encourage those on a fixed income to see if they qualify for help through the Extra Help, Medicare Savings or the Medigap Subsidy Program. Extra Help is a Social Security program that helps to reduce or eliminate prescription plan premiums, deductibles and copays for covered medications. The income limit for the Extra Help program is $1,505 for a single and $2,023 for a couple (asset limits of $13,640 for single and $27,250 for a couple). The Medicare Savings Program is a Medicaid program that will pay the Medicare Part B premium, with income limits of $1,010 for single and $1,355 for a couple (assets must be below $7,280 for single and $10,930 for a couple). The Medigap Subsidy Program through the Michigan Health Endowment Fund will provide assistance with Medigap premiums if the beneficiary has a participating policy. The income limits for this program are $1,485 for a single and $2,003 for a couple, with no asset limit. The financial assistance plans can make prescription costs more affordable for those on fixed incomes. Experts say often people are unaware that these programs are available to help and can often make a big difference for those who qualify.
Don’t procrastinate! Even though Open Enrollment seems like a long time, experts encourage people not to procrastinate and to start researching early. “We encourage people to start right away, this way if they run into questions they have time to get their questions answered and they aren’t left scrambling,” said Bob Callery, Program Coordinator at MMAP. “During Open Enrollment, our volunteers across the state as well as those that work at Medicare receive a lot of phone calls and it may take a day or two to return calls and sometimes longer, depending on the call volume. Any technical glitches with the medicare.gov website can make people anxious, so we always encourage starting early.”
Ask questions! Changes to your Medicare Prescription coverage can only be made during open enrollment, which means if you make a mistake you will be stuck for the rest of the year. Mistakes can translate into increased costs and confusion about coverage. Experts encourage asking questions to make sure you understand your coverage. “Medicare and the Prescription Drug Plans can be confusing for a lot of people, which is why we have volunteers to help,” said Callery. “If you have questions, you can look at the Medicare.gov website, call Medicare directly or call MMAP. We just ask that you understand we may not be able to return your phone call the same day, depending on call volume, but we do everything we can to answer all the questions that come to us.”
Experts also encourage those with the Blue Cross Blue Shield Legacy Medigap plans to contact MMAP today as Blue Cross Blue Shield announced this summer that they are raising the monthly premium for these plans starting January 2017. For many people, these premium prices can be a significant increase to their monthly budget. MMAP volunteers can help individuals review their options if they are enrolled in one of the BCBSM Legacy plans and wish to find a better option.
The Michigan Medicare/Medicaid Assistance Program (MMAP) is a free and unbiased statewide program made up of volunteers who can help you sort through Part D information. Volunteer counselors have gone through extensive training and can help navigate the maze of Medicare and Medicaid. To speak with a counselor, contact 1-800-803-7174.
Have questions on services for older adults and caregivers? Contact the Area Agency on Aging of Western Michigan at 616-456-5664 or 888-456-5664 or visit www.aaawm.org for more information and resources.