Medicare’s Open Enrollment period is upon is. If you’re already enrolled in a Medicare Prescription Drug Plan, are considering making changes from Original Medicare (Parts A and B) to a Medicare Advantage Plan, or are newly eligible to evaluate your Medicare options, now is your chance to make changes or enroll.
During the Open Enrollment Period you can change Medicare health plans and prescription drug coverage for the following year. Medicare health and drug plans often make changes to their policies each year, including changes to costs, coverage, and what pharmacies and providers are in their network.
It’s your opportunity to make new choices and pick plans that work best for you. Changes made during Open Enrollment are effective as of January 1, 2019.
During Open Enrollment you can:
- Join a Medicare Prescription Drug (Part D) Plan
- Switch from one Part D plan to another
- Drop your Part D coverage altogether
- Switch from Original Medicare to a Medicare Advantage plan, and vice versa
- Switch from one Medicare Advantage plan to another
- Change from a Medicare Advantage plan that doesn’t offer prescription drug coverage to one that does, and vice versa
Do I Need to Change Plans?
If you’re enrolled in a Medicare health or prescription drug plan, review the materials that your plan sent you, like the “Evidence of Coverage” (EOC) and “Annual Notice of Change” (ANOC). If your plan is changing, be sure that it still meets your needs for the following year—now is the time to review your plan so that you’re satisfied with the level of care and coverage you will receiving. Consider whether or not your health has changed, if you think you may need additional or less care in the coming year, or if your premiums and out-of-pocket expenses are too high.
Since health care and drug expenses make up a good portion of a retiree’s budget, Eric Scott Financial is available to answer your questions and help you with your options. Drug costs may differ substantially depending on the drug plan, so we suggest you review your current plan against others to see which offers the lowest out-of-pocket expenses for the particular brand-name drugs that you use.
Another reason to review drug costs is that the prices of some of those brand-name drugs could be lower this year. As part of Congress’ agreement on the nation’s budget signed by President Trump in February, some drug makers pay more of the costs for enrollees in the coverage gap, or donut hole.
Here’s how the coverage gap works, according to Medicare. After you and your drug plan have spent a certain amount of money for covered drugs, you may have to pay more for your prescription drugs up to a certain limit. In 2019, once you and your plan have spent $3,820 on covered drugs, you’re in the coverage gap. Once you reach that coverage gap, known as the donut hole, you’ll have to pay 25% of your out-of-pocket costs for brand-name drugs, down from 35% (the reduction was originally slated to take place in 2020).
You continue to pay those costs until you reach the threshold for catastrophic coverage, which for 2019 is $5,100. Once you hit that limit you have to pay no more than 5% of your drug costs for the rest of the year.
For more information about Medicare, as well as many other retirement issues, please call Eric Scott Financial at 435.773.9444.