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Finding A New Prescription Plan If Yours Is No Longer Offered

Question: I turned 65 earlier this year and signed up for Medicare and a Medicare Advantage Plan I really like. Why am I getting so much mail about insurance now?

Answer: Welcome to the Medicare Annual Open Enrollment Period (OEP)

It sounds like you did everything right when you signed up for Medicare when turning 65. You evaluated your options and chose to enroll in a plan that you felt works for you now. I am hoping you considered your physicians, your medications, your pharmacy and where you spend your time.

After that initial turning 65 enrollment, your timeline becomes the time line of Medicare year to year. Once you have Medicare and are enrolled in the additional plan of your choice you must abide by the Annual OEP, which is October 15 to December 7 each year. As you stated, you recently made your insurance decision for your first year in Medicare, you NOW need to review that decision for next year’s health insurance coverage (2022).

The Medicare OEP does not REQUIRE you to change your insurance, but you certainly should re-evaluate your plan and the new coverage rules offered for 2022.

All of the plans announce their coverage changes on October 1st of each year. During this time you have an opportunity to review the insurance plan you have and how it has changed for 2022. You can evaluate your current plan and also compare it to the other 2022 plans. You shouldn’t assume that your plan stays the same in 2022.

I often compare Medicare Insurance products to automobiles. A Ford F-150 pick-up truck of 2018 is certainly different from the F-150 pick-up truck of 2022. Each year there are new features, options and packages available.

Each year the insurance products switch it up a bit and change their product to meet what they perceive to be the needs of the market. The adjustment may be different premium (higher or lower), may be a different Medication Tier system, may be a different pharmacy network, it may be a different co-pay amount for your medications, or a different medication formulary (medications the plans cover).

If you are enrolled in a Medicare Advantage Plan (which includes Hospitalization, Medical & Prescriptions), the medical co-pays, deductibles and coverage may change for 2022.

Each year during the fall you will receive an assortment of mail about the insurance plans offered and why they think their plan is the perfect plan for you. You will see commercials on TV trying to convince you to change your insurance to that “better” plan. I am not saying your current plan isn’t good; it may be the best for you in 2022, like it was in 2021.

Your situation may be different this year as well, maybe you are taking different medications now; maybe you are using a different pharmacy. But even if your personal situation is the same as last year, your plan WILL be different in 2022! The difference may be subtle, but it should be evaluated.

Look at the material they send to you, evaluate the premium, the co-pay structure and the medication tiers. Then consider using the www.medicare.gov website to evaluate all the plans available to you. If you don’t use the internet, try calling 1-800-MEDICARE (633-4227). The Medicare customer support line is open 24 hrs. a day, 7 days a week.

If you want help with this decision, there are several unbiased agencies and programs available. Examples are Office for the Aging, Southwestern Independent Living Center and Senior Life Matters.

Don’t let this October 15 to December 7 Annual Enrollment Period pass you by! This period of time is when you can make changes to your health insurance coverage, if you decide to change your current plan, your new coverage would begin 1-1-2022.

Once you are enrolled in Medicare your birthday month is not a significant insurance factor for you. Or course you should still celebrate your special day, but don’t forget the Annual Enrollment Period of October 15 to December 7 each year. These are important dates!

So here is to a Happy Insurance Season and let’s all celebrate my favorite time of year!

Senior Life Matters is a community based program sponsored by Lutheran Jamestown. For questions and concerns or to reach Janell Sluga, GCMC, call us at 716-720-9797 or e-mail at SLM@lutheran-jamestown.org.

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