Question: Now what do I do that I don’t want to change my insurance coverage in 2021?

Answer: The Medicare Annual Open Enrollment Period is well underway and we are hearing this type of question from individuals. 2021 has more insurance plans available, but that doesn’t mean you have to or should change your coverage. When evaluating your options, see how your plan will benefit you in 2021. The medicare.gov website is a useful tool for evaluation. If you have set up and use your login and password to access the site, the information is tailored to your current coverage and how it works in the coming year. When reviewing that information, you may decide that there is not any better coverage out there regarding pharmacies and pricing. In this situation, you can just leave your insurance alone and not move to an alternate plan. This decision to stay in the plan you are in requires no action from you. The plan you are currently enrolled into rolls over into 2021 and with no action needed from you. You do not need to contact the plan representatives and you should not re-enroll into your plan. This is true for Medicare Supplement Plans, Stand Alone Part D Plans (prescription drug coverage) and for Medicare Advantage Plans of all types.

Those with Medicare are encouraged to evaluate their coverage options each year, so that they have the best possible coverage for the coming year. An individual’s health situation changes from year to year, the medications may be different, your doctors may change, and the plans may offer different coverages. So this annual evaluation is important. This evaluation process needs to include a brief review of each of those factors, as well as considering how well your plan did during this year. Are you happy with the coverage, the customer service and the pricing structures? If the answers are yes to those questions, and your medications will be covered in 2021, then stay where you are.

I do want to say that one of the big changes we are seeing this year is the change in pharmacy status. A number of the plans are changing how pharmacies are included in their coverage. The move from preferred to standard contract with Part D coverage and your pharmacy can make a significant change in the cost of your medications. In 2021 we are noticing those contracts are changing. The pharmacies that are included as preferred offer a significant savings to the enrollee when compared to the standard contract. A client and I reviewed his coverage yesterday. His current pharmacy was preferred and his medication was a $0 co-pay during the deductible and initial coverage. The alternative pharmacy that he was thinking of trying moved toa standard contract where co-pays moved to $21 each. This can also happen even when you don’t change pharmacies. Your plan may change the contract and the pharmacy you have always used is now a standard contract in 2021 instead of the preferred contract you are currently seeing.

If you have decided to stay with your current insurance coverage, you can let it roll. It is also important to remember there is still time to do that evaluation if you haven’t done it. The annual open enrollment period runs until Dec. 7. There are also other enrollment periods and special enrollment periods available if your situation changes as the year progresses.

Senior Life Matters is a community based program sponsored by Lutheran Jamestown. For questions, concerns or to reach Janell Sluga, GCMC, call 720-9797 or e-mail SLM@lutheran-jamestown.org.