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Getting Ready for Medicare Open Enrollment


Most seniors know that the Medicare open enrollment season kicks off on November 15.

And, most seniors know they’ll have until December 31 to change select their benefit option for the coming year, if they want to make a change.

This is an important time of year for seniors and their loved ones to review in detail their Medicare options. This year, as in any year, some reimbursement levels will likely change, and some out-of-pocket costs could increase. Moreover, with the difficult economy, some seniors’ retirement income may have declined, and others on fixed incomes may need to readjust their benefit levels.

Amir Mostafaie from eHealthMedicare has provided six tips to help seniors get the most out of Medicare coverage in 2010:

1. Understand your changing health care needs: If you’re managing a chronic condition, like diabetes or heart disease, make sure your 2010 coverage keeps pace with your needs for new or existing medications by seeing your primary care physician or specialist. If you’re having elective surgery in 2010, make sure your plan covers it.

2. Find out if your doctor is in the plan: The contracted networks of doctors and hospitals in private sector Medicare plans can change. Make sure your primary care physician and specialists will continue to accept the plan you’re on. (If you elect traditional Medicare, which allows you to see any doctor or visit any hospital that accepts Medicare, it’s still a good idea to confirm that your doctors are participating in Medicare.)

3. Different family members may need different plans: You and your spouse may have the same plan in 2009, but one of you may have different needs in 2010 because of a change in health. If that’s the case, review your plan options and get the right insurance for your individual needs.

4. Prescription drug coverage: If you’re taking maintenance medications for chronic conditions or anticipate changing medications in 2010, check with your physician first about them. Then review your Part D coverage, which provides coverage for prescription and generic medications, to make sure the drugs you need are covered. eHealthMedicare has a convenient ‘Doughnut Hole’ Calculator if you need help with the calculation. It lets you confirm coverage as well as research other name-brand or generic-equivalent medications that may be less expensive.

5. Look out for premium and deductible increases: Both traditional Medicare (Parts A & B) as well as private-sector plans in the Medicare Advantage program (Part C) and Prescription Drug (Part D) program are likely to have changes in 2010. They may result in savings or additional cost based on the coverage you select.

6. Seek help if you need it: Medicare changes typically come every year. But reviewing options and choosing a new plan can be confusing for consumers or those attempting to help them. For help, you can go to the government’s Web site as well as volunteer organizations, private-sector plans and other resources like the AARP (American Association of Retired People) site at aarp, the National Council on Aging (NCOA) site at ncoa and the Medicare Rights Center site at medicarerights. You can also check out the State Health Insurance Plans (SHIPs), which are part of a federal network of State Health Insurance Assistance Programs located in every state.

Readers can also try eHealthMedicare, which utilizes a very consumer-focused online interface that is easier for many people to use than some of the more complex online resources available from government and advocacy groups.



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