Medicare Open Enrollment: Questions and Answers

By Joanne McDermitt, APPRISE Coordinator, Beaver County Office on Aging

Question: What is open enrollment? 

Answer: This is the time of year that Medicare recipients can change their Advantage medical and Part D prescription drug plans. Medicare recipients can change from Original Medicare to an Advantage Plan or switch from one Advantage Plan to another. You are also allowed to change your Part D Drug Plan. Open enrollment ends on December 7. Actual coverage for your new plan will not begin until January 1. 

Question: What should I look for when comparing advantage plans?

Answer: First you want to look at the costs associated with the plan. If you have particular doctors that you want to see then you need to make sure your doctors are on those plans. This is extremely important in the case of specialists. Remember many Advantage Plans have networks of physicians that you must use to be covered by the plan. 

Question:How do I compare Part D drug plans?

Answer: All Medicare drug plans must give at least a standard level of coverage set by Medicare; however, plans offer different combinations of coverage and cost sharing. Medicare drug plans may differ in which prescription drugs they cover how much you have to pay and designated pharmacies. There are big differences among plans regarding the drugs covered and the cost.  

Question:Is it necessary to renew my current plan if I do not want to change plans?

Answer: If you are already enrolled in a Medicare Part D or Medicare Advantage Plan and don’t want to change plans, you don’t need to do anything during Open Enrollment. If your plan is being discontinued or not being renewed then you should receive a non-renewal notice from your plan. If this happens, then you will have to choose a new plan. APPRISE advises Medicare recipients to take the time each year to review their current plans to see what changes have been made to the plan. For example, the premium of your plan may have increased and no longer meets your budget. Another example is checking to make sure your prescription drugs are still covered under your plan. It is not unusual for drug plans to make changes on what drugs they will cover as well as the cost of those drugs. 

Question:Does open enrollment affect those with Medigap Supplement Plans?

Answer: If you have a Medigap Supplement Plan, Open Enrollment does not affect you unless you want to leave the Medigap Plan and switch to an Advantage Plan.  

Question: What online resources are available to help?

Answer: The Medicare Plan Finder is an online resource to help you view and compare all available drug and health plan choices. To find and compare available plans in your area, visit the Medicare Plan Finder at Search by ZIP code or use your account for information tailored just for you.

Question: How can APPRISE help with open enrollment?

Answer: APPRISE works individually and confidentially with clients to determine their individual health care needs and preferences, compare health insurance options, plan ahead for long term living, and obtain Medicare and supplemental coverage that fits their lifestyle and their budget. APPRISE counselors conduct a benefits checkup for clients to determine if someone might be eligible for additional benefit programs that would reduce their out-of-pocket expenses for prescription co-pays, monthly premiums and annual deductibles.  

Question:How do you contact APPRISE?

Answer: The Beaver County APPRISE Program can be reached at (724) 847-2262. Their offices are in the Human Service Building, located at 1020 Eighth Avenue in Beaver Falls.