Open Enrollment

Medicare logoThere are several open enrollment periods now in health insurance. Depending on your health insurance situation, you may wonder when you should be checking on your insurance needs. On October 15th, open enrollment began for Medicare beneficiaries. Medicare recipients can review their prescription drug plan to decide if it meets all their medication needs. If not, they have until December 7th to choose a new drug plan.

There are many different Medicare prescription drug plans available in Illinois. These plans are approved by Medicare, but administered by private companies. Reviewing your options each year is important as drug coverage, co-pays, deductibles, and premiums can change dramatically from year to year.

A crucial factor when deciding whether your current Medicare prescription drug plan serves your medication needs is whether your medications will continue to be covered by your plan next year. Medicare prescription drug plans can change their medication list, also known as a formulary, with Medicare’s approval.

Medicare’s website, at www.medicare.gov, has a link to “Find Health and Drug Plans” that anyone with an Internet connection can use to find the plan that best fits their medication needs and pocketbook. This is important since not all plans cover every medication. The formulary, monthly premium, and deductible vary from plan to plan.

Individuals who do not have access to the Internet can obtain information about plans by making an appointment at their local senior citizen center. The social service staff members at senior centers are trained to assist people with their Medicare prescription drug plan.

For many Medicare beneficiaries, the monthly premium and co-payment costs for their drug plan is financially difficult. Help is available through a program that helps low and moderate-income beneficiaries pay these costs. The program is called Extra Help (or sometimes referred to as a low-income subsidy). Your local senior center can help you determine if you are eligible for this program.

Finally, senior centers help low-income Medicare beneficiaries determine if they are eligible for other programs that help with Medicare’s out-of-pocket costs for Part A and Part B; which covers hospital, doctor, and other medical services. These programs help with the co-payment amounts for hospitals and/or monthly premiums and co-payment amounts for doctors and other medical services.

For people on Medicare and Medicaid, the Medicare Medicaid Alignment Initiative (MMAI) also has an open enrollment period for choosing a specific health plan. The insurance company will send you a letter when it is open enrollment time, which is at the anniversary date of the plan.

The Affordable Care Act’s Marketplace has open enrollment from November 1st through January 15th. Without a significant life event, you will not be able to make changes to your insurance until the following year if you miss this timeframe to change.

Call Egyptian Area Agency on Aging at 1.888.895.3306 for information and/or assistance concerning health insurance. You can also call your senior center for an appointment to review your medications and drug plan or ask about information on benefit programs or other insurance programs. In addition, you can visit us on the Internet at www.EgyptianAAA.org.

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