Choosing the Best Option During Medicare Annual Enrollment

Choosing between the many different Medicare options that take place during the “Medicare Open Enrollment Period,” which takes place from October 15 to December 7 can be puzzling. During this period, current Medicare users can re-evaluate a portion of their coverage and compare it against other available plans on the market.

In this article, we help you to unravel and understand the options available to you.

For starters, current Medicare users can re-evaluate their Medicare Advantage and/or their Part D plans in order to determine if there’s a better fit on the open market. If there is a better fit, users can switch, add or abandon a Medicare Advantage and/or Part D plan accordingly.

The Medicare Open Enrollment Period cannot be used to enroll in Part A or Part B of the Medicare program. Those periods come up at a different time in the calendar year.

It helps, then, to consider the Medicare Open Enrollment Period as a period of re-evaluation and decision-making. The central focus during this timeframe is the Medicare Advantage and Part D plans.

To that end, users who have Plan A or Plan B Medicare coverage can either enroll in or abandon the Part D plan. And users who have Plan A or Plan B Medicare coverage can switch their existing plan to the Medicare Advantage program. Users with a Medicare Advantage plan can switch to a new Medicare Advantage plan or Plan A or Plan B Medicare coverage. And users with Plan D coverage can switch to new Plan D coverage.

Identifying Medicare Plans

It’s helpful to identify exactly what the different plans of the Medicare program are.

Plan A is known as “hospital insurance.” This is self-explanatory, as Plan A Medicare insurance covers hospital or hospice care. It also covers care if users are staying in a skilled nursing facility or are otherwise receiving certain types of health care in the home. There are terms and conditions associated with Plan A depending on particulars, but Plan A is generally associated with inpatient services.

Plan B provides coverage for outpatient services and things associated with testing or lab services. This part of the Medicare plan is optional, but it does pertain to services like X-rays, lab and diagnostic testing, blood transfusions, vaccinations, chemotherapy, some hormonal therapies, and other outpatient treatment options. It also covers equipment, like canes or wheelchairs, and implements like oxygen for home use.

Plan A and Plan B coverage is considered under the umbrella of Original Medicare, also known as fee for service Medicare or traditional Medicare.

Part C coverage is also known as Medicare Advantage. This is coverage that pays for managed health care on a monthly fee basis. These are private health plans that contract with Medicare to administer coverage for the same things as Original Medicare, plus there may be extra services or variables depending on the specifics of the plan.

Part D coverage, which went into effect in 2006, is a prescription drug plan. This coverage is offered to anyone with Medicare and is administered through an insurance company or another private company that is approved by Medicare. The specifics of Plan D coverage vary from plan to plan, plus the details can change annually.

Why Open Enrollment is Important

The options available through open enrollment are important because they let consumers switch to more accommodating plans. Most people can keep their doctors and save hundreds of dollars a year if switching proves effective, plus prescription drug plans vary frequently and can be re-evaluated accordingly.

Due to the nature of the program, health insurance is not a “set it and forget it” choice. Programs evolve and insurance companies make variations to policy details, which can make staying on top of things problematic. The open enrollment period provides an opportunity to evaluate specifics, like how much you may pay out of pocket in terms of monthly premiums and deductibles.

Because there are often many changes to plans throughout the calendar year, the Medicare Open Enrollment option lets users find higher quality plans and save money while preserving access to in-network doctors and other relevant particulars to specific programs.