“It’s fall? Again?! It’s like it happens every year or something.”
As the heat and leisure of summer begin to melt away once again into golden leaves and frosty mornings, it’s easy to wonder where on earth the time has gotten away to. This feeling can be especially true for Medicare beneficiaries who are preparing to enter the 2021 Annual Enrollment Period once again.
But what is Medicare Annual Enrollment and why should you care about reviewing your plan every year? Savvy boomers know that making the most out of their Medicare is a lot like coaching a winning football team: It takes a strong game plan.
They remember that their Medicare plans and benefits can change from year to year, and rely on annual reviews and help from local agents to ensure they’re getting the most out of their Medicare.
The Medicare Annual Enrollment Period happens every year from October 15th to December 7th. During this time, if you’re in a Medicare Advantage Plan and want to change your health plan, you can do one of these: Switch to a different Medicare Advantage Plan with or without drug coverage or go back to Original Medicare and, if needed, also join a Medicare Prescription Drug Plan. However, with the surplus of information surrounding your benefits and options, it can be difficult to discern which option is right for you.
Even though the Annual Enrollment Period doesn’t officially start until October 15th, for most people the floodgates seem to open about two weeks earlier around October 1st. This is because the Center for Medicare and Medicaid Services (CMS) has strict rules around when insurance companies and brokers can begin marketing the next year’s plans to the general public. CMS forbids discussing or sharing any specific plan details until after October 1st, so most companies begin their heaviest marketing during this time period. That’s why you can always count on seeing a ton of Medicare-related commercials and mailers right around the time all the Halloween candy starts appearing in stores!
All of the information and options can feel overwhelming to even seasoned Medicare shoppers, but working through the following guidelines can help you make the most out of your Annual Enrollment Period and your healthcare for the year to come.
So what should go into your AEP game plan?
• Review your current benefits. To know where you need to go, you need to know where you’re starting first. The key things to verify are:
1. You’re entitled to Medicare Parts A and B. This part is easy! For most people, it’s as simple as looking at their Red, White, and Blue Medicare card. Look at the effective dates next to Hospital (Part A) and Medical (Part B). As long as you see effective dates next to each of these, you should be able to check this box off! If you can’t find your Medicare card, aren’t sure about your benefits, or simply want to double-check, you can create a MyMedicare account at Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
2. What Medicare Supplement, Medicare Advantage Plan, or Prescription Drug Plan you have. The easiest way to check what plan you’re on is to look at the membership card your insurance company sent you when you enrolled in the plan. These cards look different between companies and plans, but most are white and should list your insurance company’s name, the plan you’re on, as well as key information like copay costs and member help number. If you have the card but can’t figure out what plan you’re on, try calling the number on the back of your card for assistance. If you can’t find the card at all, you can check your MyMedicare account or call 1-800-MEDICARE or 360-771-1155 for guidance.
3. If you have Medicaid or any other government financial assistance. Medicaid (Not to be confused with MediCARE) is a government program that helps individuals with limited financial resources afford healthcare. In Washington State, Medicaid cards are called ProviderOne cards. They’re a blue/green color and have a picture of George Washington on the front. Having both Medicare and Medicaid could make you eligible for special plans specially created for folks who are “dual-enrolled” in both programs. These plans often feature lower out-of-pocket costs and other helpful benefits! These are the plans that pro athletes such as Joe Namath mention in TV commercials.
• Assess your needs. Once you know what your current benefits look like, start thinking about your current health needs. Are they the same as the day you first enrolled in your plan or have a few things changed? You should consider the following:
1. Doctors: This includes specialists like cardiologists, dermatologists, physical therapists, etc. Is there anyone you’d like to see who may not be in your plan’s Medicare network?
2. Medications: What medications do you take? Have any of your prescriptions or dosage amounts changed? Would you like to see if another plan charges less for your particular prescription drug?
3. Conditions and Upcoming Procedures: Have you been diagnosed with anything recently like diabetes or hearing loss? Are you anticipating needing any surgeries or procedures in the next year? These are important conditions to plan around!
• Give your plan a performance review! Think about how your plan has cared for you over the past year. Have you had any bills that were a lot higher than you expected? Have you noticed that some of your doctors no longer take your insurance? Take a few moments to really think about things you like about your plan, things you really dislike, and things that would make your plan better.
• Talk to an agent. Now that you’ve got a good working knowledge of what you like and dislike about your current plan, talk to a local insurance broker about your health insurance needs. A local independent broker like the agents with Your Insurance Gal Agency contract with the top insurance companies in the area, and they can help you compare plan benefits across multiple companies. Because they live, work, and go to the doctor in the same places as you, they’ll be able to give you unbiased advice on your options and help you find what’s best for you.
• Decide and enroll. Your agent will help you narrow down your many options to one or two strong choices. Once you decide what plan you want, your agent can either send you a virtual application to fill out, or they can help you finish and submit it in the same meeting!
While all this information can seem like a lot to deal with, most people who start with an agent usually find their next year’s plan in under an hour. Whether you’re a quick shopper or someone who likes to really think things over, a local agent such as the agents at Your Insurance Gal Agency can help illuminate the path for you and make sure every aspect of your health is being accounted for.