It’s that time again – the Medicare Annual Election Period (AEP), also known as Open Enrollment.  This is the time for those of you who are 65 and older, or disabled, to select or make changes to your Medicare plans.  For everyone else, your turn is coming soon – November 1st marks the open enrollment period for individuals.

By now you should have received plenty of information from your health insurance plan.  Right?  It’s probably on the coffee table, or in that pile of mail.  At least that’s how things look at my house.

Here’s what you need to know:

Medigap Policies

People with Original Medicare can choose whether to also buy a Medigap policy, which is also called a Medicare supplement policy. Medigap policies fill, to varying degrees, the holes in Original Medicare. The biggest hole is that Original Medicare pays only 80 percent of covered expenses, leaving beneficiaries on the hook for the other 20 percent. As anyone who’s stayed in a hospital or had major surgery knows, that can be 20 percent of a very, very big number.

If you don’t have Medigap or even if you do, you can select a Medigap plan during open enrollment. There are 10 different Medigap “letter” plans. Coverage within each type of plan must be identical. This means that all letter A plans are the same, all letter B plans and so on. But premiums can and do vary a lot. So shopping around for the best rate is a must. Specific coverage requirements of the various plans have not changed much from last year. You can find them on page 101 of “Medicare & You 2016.”

Medicare Advantage Plans

People with Original Medicare also have the option during open enrollment of buying a Medicare Advantage plan. And those with Medicare Advantage can pick a different Medicare Advantage plan. They cannot be denied coverage or required to pay more because of pre-existing conditions. (An exception to this rule is that people with end stage renal disease are not eligible for Medicare Advantage plans.)

Medicare Part D Prescription Plans

Some Medicare plans cover prescriptions or Part D, some do not.  Be careful here as enrolling in the wrong plan could disrupt your health coverage.  Prescription coverage is not 100% – there are deductibles, copays and a coverage gap (also known as the doughnut hole).  However, failure to enroll in a Medicare Part D plan could result in a penalty.  We don’t want that now do we?

Yes, it’s confusing I know.  But we can get through it and help you find the plan that works best for you or your family member.

If you have questions, please call.  I’m happy to help you navigate the health insurance web.

Best,
Laura

PS:  Don’t forget that Open Enrollment for Individuals starts November 1st!