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Annual Medicare Open Enrollment Period: October 15th-December 7th

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The Annual Medicare Open Enrollment Period, also known as Annual Election Period (AEP) begins October 15th and ends December 7th. This is the time when you can shop for a new Medicare Advantage or Part D plan for the 2015 calendar year.

During the Annual Election Period we recommend that you give your Medicare Advantage health plan a check-up to ensure your health plan meets your needs in the coming year. For details, we talked with THIPA’s Member Services Manager, Loretta Morrow and Insurance Consultants Vince Kelly and Susan Arbour.

Healthy Living: How do you give your Medicare Advantage health plan a check-up?

Vince Kelly, Insurance Consultant: You start with your mailbox. Every member will receive a packet in the mail from his or her current Medicare Advantage health or drug plan company. You must read this packet. I know it’s a lot of information, but inside there’s an Annual Notification of Change document.

Susan Arbour, Insurance Consultant: The Annual Notification of Change document will contain a benefit grid that allows you to compare your 2014 heatlh plan benefits to the 2015 plan benefits. For instance, perhaps in 2014 you had a transportation benefit that you enjoyed. The grid will show you if your health plan is going to offer that same or a similar benefit in 2015. If they no longer do, that may be one reason to shop for a new plan.

Loretta Morrow, THIPA Member Services: It’s also important to assess your changing medical needs. Perhaps you’re newly retired and need a gym benefit. Or, maybe you are planning world travel; you will also want to consider your health plan’s worldwide Emergency Room and Urgent Care coverage. I encourage members to also pay close attention to their health plan’s Out-Of-Pocket Maximums. The point is, make sure your existing medical needs and the benefits your plan offers match up.

Vince: That’s great advice, Loretta. It’s why I tell seniors to look at the drug formulary. It comes in the packet with your Annual Notice of Change. You need to look up all the drugs you’re taking and check their cost. For instance, in 2014 maybe your blood pressure medication was listed as a Tier 1 drug and now it’s a Tier 2 drug. Instead of paying $5 for your prescription, you’ll pay $10. For some people these little changes can add up significantly.

Susan: I remind my clients that the health plans provide the Annual Notice of Change to help them review their existing benefits, but sometimes this is not enough. There are a few other helpful tools that a person can use to determine how their current health plan measures up against the other health plans that are being offered for the new year.

  1. Medicare & You Handbook – mailed to Medicare Beneficiaries every October. This book lists all the Medicare Advantage HMO, PPO and Rx drug plans by county with a short summary of their 2015 benefits.
  2. www.Medicare.gov – this government website can help you to see all the Medicare Advantage HMO, PPO and Rx Drug plans in your area. It can provide specific drug costs under each plan and a short summary of benefits for 2014 and 2015.
  3. THIPA 2015 Medicare Benefits Fair – THIPA is conducting a 2015 Medicare Benefits Fair on Saturday November 1, 2014 9:30-11:00 AM at the Torrance Memorial Hoffman Health Conf. Center; Rooms 1 & 2, located at the Torrance Memorial Medical Center. – At this event you can hear short presentations from all of the contracted health plans that THIPA members can join.
  4. Local Insurance Consultants / Agents– Vince and I work year round to help individuals identify ALL of their options on Medicare. At Open Enrollment we work especially hard to assist our current and new clients with evaluating their choices for the coming year. If you choose to use an Insurance Agent, please make sure that they are knowledgeable about the area that you will be seeking services from, also that they offer ALL your options on Medicare, not just a few health plans. It will help you to see a complete picture of what’s available to you and allow you to make an informed decision for the coming year.

Loretta: Another thing, if you have been thinking about changing your primary care physician, now is a great time to do that. You can review the most recent provider directory online at thipa.org/ physciandirectory. You can also call THIPA’s Member Services team and we can help you select a new primary care physician. Remember, you can change your primary care physician at any time, not just during the Annual Election Period.

Susan: Something helpful to know is that if you do change your Primary Care Physician or your health plan, you will receive a new insurance card. When you receive your new card, please be sure to check that your Primary Care Physician and your Medical Group is listed correctly. If it is not, please call your health plan and ask them to correct the error for you. A corrected card will be mailed out to you within 7 to 10 working days.

Vince: You’ll be receiving a lot of marketing from health insurance companies during this time. The way some companies are wording their material may lead you to believe that you must sign up for a certain supplement or drug plan. Don’t be swayed by something you read in the mail. You do NOT have to change anything if your current health plan meets your medical and financial needs.

Susan: Vince is right. Carefully compare the benefits of each health plan you’re considering with your existing Medicare Advantage health plan before making any change. If you have questions, you can call an insurance consultant like Vince or myself and we will go over the health plans with you. We do not have a vested interest in any one health plan. Our job is to help you find the health plan that is right for you.

Vince: You also should avoid chain emails that are designed to scare you. There’s one going around that says Medicare Part B premiums will go up considerably in 2015. The truth is, there’s no way anyone can know this. The only accurate information about the cost of future Medicare Part B premiums will come from the Medicare and typically this has been by November 15th of each year.

Loretta: It’s also important to remember that if you do nothing during Medicare Open Enrollment Period the Annual Election period, your current Medicare Advantage health plan Plan will remain the same and any benefit changes will become effective January 1st 2015.

Healthy Living: Thanks so much, Loretta, Vince and Susan. If you still have questions, you can call THIPA