Medicare Open Enrollment

WHAT IS THE MEDICARE OPEN ENROLLMENT PERIOD?

The Medicare open enrollment period is the time during which people on Medicare can make new elections between Original Medicare (Parts A and B) or Medicare Advantage (Part C); and, their Prescription Coverage (Part D) if they are on Original/Traditional Medicare.


WHEN DOES THE OPEN ENROLLMENT PERIOD START?

The Medicare open enrollment period begins on October 15th and runs through December 7th. Any changes made during open enrollment are effective as of January 1, 2018. During the open enrollment period you can:

  • Join a Medicare Prescription Drug (Part D) Plan
  • Switch from one Part D plan to another Part D plan
  • Drop your Part D coverage altogether
  • • Switch from Original Medicare (Parts A and B) to a Medicare Advantage Plan (Part C)
  • Switch from a Medicare Advantage Plan to Original Medicare
  • Change from one Medicare Advantage Plan to a different Medicare Advantage Plan – there are up to six choices, depending upon where you live
  • Change from a Medicare Advantage Plan that offers prescription drug coverage to a Medicare Advantage Plan that doesn't offer prescription drug coverage
  • Switch from a Medicare Advantage Plan that doesn't offer prescription drug coverage to a Medicare Advantage Plan that does offer prescription drug coverage


DOES THE OPEN ENROLLMENT PERIOD PERTAIN TO MEDIGAP POLICIES?  NO!

Medigap policies are handled through private insurance companies. Most of our readers buy Medigap policies to supplement Original Medicare. If this is the case for you, then many of the above options do not pertain to you.

The best time to buy a Medigap policy is during the 6-month Medigap open enrollment period upon turning age 65. During that time you can buy any Medigap policy sold in your state even if you have health problems. After this enrollment period, you may not be able to buy a Medigap policy, or, if you are able, it may cost more. If you simply want to change your existing Medigap plan, you can do that at almost any time if you qualify (very limited circumstances). Don’t cancel an existing policy until you have secured an alternate policy!


WHAT SHOULD YOU DO?

Now is a good time to review your current Medicare plan. As part of the evaluation, you may want to consider several factors. For instance, are you satisfied with the coverage and level of care you're receiving with your current plan? Are your premium costs or out-of-pocket expenses too high? Has your health changed, or do you anticipate needing medical care or treatment?

Open enrollment period is the time to determine whether your current plan will cover your treatment and what your potential out-of-pocket costs may be. If your current plan doesn't meet your health-care needs or fit within your budget, you can switch to a plan that may work better for you.


WHAT'S NEW IN 2018?

The initial deductible for Part D prescription drug plans increases by $5 to $405 in 2018. Also, most Part D plans have a temporary limit on what a particular plan will cover for prescription drugs. In 2018, this gap in coverage (also called the "donut hole") begins after you and your drug plan have spent $3,750 on covered drugs — a $50 increase over the 2017 initial coverage limit. It ends after you have spent $5,000 out-of-pocket, after which catastrophic coverage begins. However, part of the Affordable Care Act gradually closes this gap by reducing your out-of-pocket costs for prescriptions purchased in the coverage gap. In 2018, you'll pay 35% of the cost for brand-name drugs in the coverage gap (65% discount) and 44% (56% discount) of the cost for generic drugs in the coverage gap. Each succeeding year, out-of-pocket prescription drug costs in the coverage gap continue to decrease until 2020, when you'll pay 25% for covered brand-name and generic drugs in the gap.

Medicare beneficiaries who file individual tax returns with income that is greater than $85,000, and beneficiaries who file joint tax returns with income that is greater than $170,000, pay an additional monthly premium or Income-Related Monthly Adjustment Amount (IRMAA) for their Medicare Part D prescription drug plan coverage. In 2018, some of these beneficiaries will see their IRMAA increase by as much as 58%, while other beneficiaries may actually see their IRMAA drop. For more information, visit the Centers for Medicare & Medicaid Services website, www.CMS.gov.


WHERE CAN YOU GET MORE INFORMATION?

Determining what coverage you have now and comparing it to other Medicare plans can be confusing and complicated. Pay attention to notices you receive from Medicare and from your plan, and take advantage of help available by calling 1-800-MEDICARE or by visiting the Medicare website, www.medicare.gov.