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Medicare Open Enrollment – A Time To Evaluate And Make Changes

Medicare Open Enrollment – A Time to Evaluate and Make Changes

The arrival of autumn brings about the changing leaves, pumpkins and cooler weather. It also brings about Medicare open enrollment. Open enrollment, which happens between October 15 and December 7, provides the opportunity for current participants in Medicare to evaluate their drug plans and supplemental coverage and to make any necessary changes. (Open enrollment is not the time for new participants to sign up for Medicare).

For Medicare participants who have prescription drug plans (Part D) or are enrolled in Medicare Advantage plans (with or without drug coverage) it is important to take advantage of the opportunity of open enrollment and to not just assume that this past year’s coverage is still the best and most cost-effective coverage.

Why you should evaluate your plan every year

There are annual changes to drug plans that may impact the coverage and cost of the drugs that participants take. Also, new drug plans enter the marketplace and may provide similar coverage at a cheaper price. Every participant of a drug plan should receive an annual document called “Evidence of Coverage.” It is in this document where a drug plan’s current coverage is explained and the participant is notified of what changes are going to take place in the coverage. We advise clients to carefully review this document and to look at the following items:

  • Monthly premiums
  • Drug formulary
  • Medication tiers
  • Annual deductible
  • Copayments of coinsurance
  • Coverage rules
  • Additional benefits in the Coverage Gap
  • Pharmacy networks
  • Quality ratings of plans

For those who want to shop for a new drug plan, the Medicare Plan Finder is a great place to start.

Medicare Open Enrollment Dates
Beginning Date:October 15, 2019
End Date:December 7, 2019
Effective Date of any changes made during open enrollment:January 1, 2019

Medicare Advantage Plans

For Medicare Advantage (MA) plans (which are run by insurance companies and structured in HMO and PPO formats) it is important for the recipients to not only review the “Evidence of Coverage” documents to see changes in their drug coverage but to learn of changes that may impact what doctors they can see and which medical facilities they are able to access. MA plan recipients should pay close attention to the following during their review:

  • Monthly premium
  • Annual deductible
  • Annual-out-of-pocket spending limit
  • Your out-of-pocket costs (co-payments, coinsurance)
  • Provider network
  • Quality ratings of plans
  • Optional benefits such as dental or vision

If you decide to make a switch you can call 1-800-MEDICARE or the insurance provider of the new plan. Alternatively, you can go online to medicare.gov or the insurance carrier’s website.

The following actions can take place during open enrollment:

  • For those with Original Medicare (Part A, B, D and a Medigap policy)
    • Drop Original Medicare and switch to a Medicare Advantage plan (it is important to note that a participant may not be able to switch back to Original Medicare at a later date if medical underwriting reveals a pre-existing health condition that an insurance company will not cover).
    • Change, enroll in or drop Part D coverage
  • For those with Medicare Advantage plans
    • Switch to another MA plan with or without drug coverage

If you do decide to make a change to your current coverage the change will go into effect on January 1 and at that time you should be automatically unenrolled from your old coverage.

If upon review of your current coverage you find that it is still the best coverage for you, you do not have to do anything to stay in your current plan and you will automatically be re-enrolled by your current provider.

Take a look under the hood

We recommend that all Medicare recipients take advantage of the open enrollment period in order to take a look “under the hood” of their current Medicare coverage. This exercise is important to avoid paying more than you have to (i.e., higher premiums) and to make sure that you understand what is and what is not covered by your insurance. Once you are clear, you may want to adjust your financial plan accordingly.

Medicare decisions are important to your overall financial plan.  We recommend that you discuss the choices with your Wealth Advisor, who will be able to serve as a resource to determine the right coverage for you.

Changes you are eligible to make during Open Enrollment period
If you are a traditional Medicare participant…If you are a Medicare Advantage participant….
Drop traditional Medicare and switch to a Medicare Advantage planSwitch to another Medicare Advantage plan with or without prescription drug coverage
Change, enroll in or drop a part D prescription drug planDrop Medicare Advantage and switch to traditional Medicare (however coverage can be denied by insurance companies based on pre-existing health conditions)

Important disclosure information

Please remember that different types of investments involve varying degrees of risk, including the loss of money invested. Past performance may not be indicative of future results. Therefore, it should not be assumed that future performance of any specific investment or investment strategy, including the investments or investment strategies recommended or undertaken by RegentAtlantic Capital, LLC (“RegentAtlantic”) will be profitable.

Please remember to contact RegentAtlantic if there are any changes in your personal or financial situation or investment objectives for the purpose of reviewing our previous recommendations and services, or if you wish to impose, add, or modify any reasonable restrictions to our investment management services. A copy of our current written disclosure statement discussing our advisory services and fees is available for your review upon request.

This article is not a substitute for personalized advice from RegentAtlantic. This article is current only as of the date on which it was sent. The statements and opinions expressed are, however, subject to change without notice based on market and other conditions and may differ from opinions expressed in other businesses and activities of RegentAtlantic. Descriptions of RegentAtlantic’s process and strategies are based on general practice and we may make exceptions in specific cases.

RegentAtlantic does not provide legal or tax advice. Please consult with a legal and or tax professional of your choosing prior to implementing any of the strategies discussed in this article.

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