5 Things to Know about Medicare Open Enrollment

Corinne Lofchie is an Elder Care Advisor and SHINE Counselor at Somerville-Cambridge Elder Services

Medicare Open Enrollment runs from Oct. 15 to Dec. 7, and it’s the one time of year that all Medicare recipients can change between any of the Medicare plan options.  Medicare plans often change, so we recommend reviewing coverage annually, to ensure that your coverage will still be a good fit in the coming year.

Somerville-Cambridge Elder Services (SCES) provides free and unbiased Medicare counseling through a program called SHINE (Serving the Health Insurance Needs of Everyone). We asked SCES SHINE counselor Corinne Lofchie for some tips on Medicare Open Enrollment 2020, and this was her advice:

Be Mindful of Name Changes Have you ever received a notification that your plan name is changing? If that happens, it’s a good idea to review the specifics of the new plan.

We had this happen this year. One of the cheapest plans had a name change, and people who were in that plan will automatically be enrolled in the new version for the coming year. Unfortunately, the new plan is twice as expensive. This happens from time to time, so review the terms if your plan changes names. A different plan might be a better fit.

Medicare Medical Savings Account Medicare Advantage Plans are a private model for getting Medicare insurance. They typically replace Medicare insurance with Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO) plans, which are similar to employer plans.

This year, there is a new type of plan available in our area: a Medicare Medical Savings Account. Under this model, the insurance company puts a certain amount of money into an account, and you use that to pay for medical care. If that account is used up, the person receiving coverage would need to pay a certain amount of expenses out-of-pocket. After that amount, the plan would pick up the rest of expenses, excluding medications. You also need a Medicare Part D plan along with this type of plan.

There is only one company offering this in Massachusetts right now and they have two plans, both of which are free. One plan starts with a $2,000 account, followed by $3,000 of out-of-pocket expenses. The other starts with $3,000, with $5,000 out-of-pocket afterward.

We haven’t seen these plans in action yet, but they could be good for people who anticipate small medical costs. Insurance plans that cover everything are often about $200 per month—so that’s about $2,400 per year. The cheaper savings plan covers the first $2,000, and has a maximum of $3,000, so it could be good for some people.

Need Insulin? There is a new program for people who take insulin, which is often very expensive on Medicare plans. Part D Senior Savings is an optional program that caps the co-pay for some insulin medications at $35 per month. It’s usually more than that, so this can lower the cost, if you pick a Part D plan that offers this program.

SHINE is Here to Help SHINE counselors are volunteers who have undergone 40 hours of training, with the goal of helping others receive the best possible Medicare Advantage of Prescription Drug plans. To set up an appointment with a SHINE counselor, contact the Aging Information Center at Somerville-Cambridge Elder Services. There are a limited number of SHINE slots, so it’s best to call early.

Bonus Tip The Medicare website has become more user-friendly over the years. By logging on and creating a My Medicare Account, users can see their current coverage and costs, make changes, and compare plans. SHINE counselors can also provide help for people who are new to that process.

Corinne Lofchie, LICSW is an Elder Care Advisor and SHINE Counselor at Somerville-Cambridge Elder Services (SCES), a not-for-profit that supports independence and well-being of older adults in Somerville and Cambridge. For free and advice and guidance on questions of aging, caregiving, or disability, contact our Aging Information Center at 617-628-2601 or email info@eldercare.org.