5 Things to Know for Medicare Open Enrollment

Are you getting the best possible health insurance through Medicare? The annual open enrollment period is the time to revisit this question, to ensure your coverage is optimized.

Colleen Morrissey is a Resource Specialist at Somerville-Cambridge Elder Services

Medicare Open Enrollment is the annual period when beneficiaries can make changes to their coverage. Between Oct. 15 and Dec. 7, people with Medicare can switch to other Part D or Medicare Advantage (Part C) plans that take effect in the upcoming year.

At Somerville-Cambridge Elder Services (SCES) our Aging Information Center provides free access to experts in Medicare, who can explain what to do – and what not to do – during open enrollment. Here are five tips to get you started:

  • Always review your coverage Part D plans provide drug coverage. Medicare Advantage plans provide both drug and health coverage. Either type might make changes to the prescriptions they cover or costs. Or maybe you have a new prescription – it might not be covered by your current plan. There are a lot of moving parts, and we recommend reviewing every year to ensure the best coverage.
  • Apply for Extra Help Extra Help is a federal program that helps with Part D costs, including premiums, deductibles, and co-pays. Eligibility is based on income and assets. If you don’t qualify for Extra Help, you may still qualify for a state program called Prescription Advantage. You can complete the form for Extra Help online, or contact Prescription Advantage to apply for both programs at 1-800-243-4636 and select option 2.
  • Contact the Pharmacy Outreach Program MCPHS University also provides free assistance with lowering drug costs, and answers questions about medications. Call 1-866-633-1617 or visit their website.
  • Don’t choose your coverage based on the plan name Never assume that the private insurance company you had while working or the plan recommended by friends will necessarily provide the best Medicare options for you. Your best plan is based on specific prescriptions and health needs, which may not be the same as friends and family.
  • Meet with a SHINE counselor We can’t stress this enough. SHINE (Serving the Health Insurance Needs of Everyone) is a federal program, with counselors who receive over 40 hours of training in Medicare. They specialize in navigating the Medicare system. The program is free; consultations are one-on-one. To find a SHINE counselor in your area, call 1-800-243-4636 and select option 3 for landline/option 5 for cell phone.

And one last tip: don’t wait until December to seek help from a SHINE counselor– most will already be booked by then.

By Colleen Morrissey, SCES Resource Specialist. SHINE Counselors Corinne Lofchie and Lee Ann Lowe also contributed to this report.