Marci’s Medicare Answers: Fall Open Enrollment starts soon

Dear Marci,
I received a flier from my senior center telling me to review my Medicare coverage during Fall Open Enrollment. What is Fall Open Enrollment? —Frank

Dear Frank,
Fall Open Enrollment is the time of year when Medicare beneficiaries can make changes to their Medicare coverage. It lasts from Oct. 15 to Dec. 7 of each year. During this time, you can join a new Medicare Advantage plan, join a new stand-alone Part D prescription drug plan, or switch to Original Medicare with or without a stand-alone Part D plan. Any changes made during Fall Open Enrollment go into effect Jan. 1. 2015.
Even if you are satisfied with your current Medicare coverage, it’s important to investigate during Fall Open Enrollment whether other Medicare options may better suit your individual needs in the next calendar year. Research shows that people with Medicare prescription drug coverage (Part D) could lower their costs by shopping among plans each year. If you have Original Medicare, you will receive the annual guide to Medicare called Medicare & You. Read through the handbook for any cost sharing and/or coverage changes in the following year. If you are unsatisfied with your coverage for the following year, you can enroll in a Medicare Advantage plan during Fall Open Enrollment.
If you have a Medicare Advantage or Part D plan, you will receive an Annual Notice of Change. Review this notice to ensure that your doctors and pharmacies will be in-network next year and that your prescription drugs will still be included on your plan’s formulary. If you are unsatisfied with your coverage, you can enroll in a new Medicare Advantage plan, enroll in Original Medicare, or enroll in a new Part D plan.
Call 800-Medicare to enroll in Original Medicare or to find out what Medicare Advantage plans and Part D plans are in your area. You can contact plans directly to ask about their coverage, but it is best to enroll in a plan by calling 800-Medicare. This is the best way to protect yourself in case problems occur.
In many cases, this is the only time during the year that you can change your Medicare Advantage plan or Part D plan, and it is important to take advantage of this opportunity. —Marci

Dear Marci,
My Medicare Advantage plan is ending at the end of the year. What are my options for getting my Medicare coverage? —Saul

Dear Saul,
If your Medicare Advantage plan is ending, you have a few options to consider for your Medicare coverage.
You should receive a notice by Oct. 2 if your Medicare Advantage plan is ending at the end of the calendar year. Keep this letter for your own information. It may also list other Medicare Advantage plans in your area.
If you want to enroll in another Medicare Advantage plan, call 800-Medicare to get a list of plans in your area. Remember, Medicare Advantage plans have different rules for how and where you can get coverage for services. Verify that a plan includes all of your doctors and/or pharmacies in its network and that its drug formulary covers all of the prescription drugs that you need. You can call 800-Medicare directly to enroll in a new plan. You have until Dec. 31 to enroll in a new Medicare Advantage plan; otherwise, you will be automatically enrolled into Original Medicare. Either way, your new coverage will be effective starting Jan. 1.
If you want to enroll in Original Medicare, you can call 800-Medicare to do so. Remember that you will also have to select a stand-alone Part D prescription drug plan. By calling 800-Medicare, you can get a list of the Part D plans in your area. You can also use the Plan Finder tool on the Medicare.gov website to compare plans and find a plan that covers your prescription drugs.
In this situation, it is important to make a timely decision regarding your Medicare coverage. If you decide to enroll in a Medicare Advantage plan, you should do so before Dec. 31. Otherwise, you will have to wait until the next Fall Open Enrollment to make changes to your coverage. —Marci

Dear Marci,
I have the Extra Help benefit for prescription drugs and received a gray-colored notice. What does this mean? —Shannon

Dear Shannon,
If you receive a gray notice in relation to Extra Help, the federal benefit that assists with prescription drug costs for those with limited finances, it means that you have lost your deemed status for next year, and you will no longer qualify for Extra Help starting next year.
Individuals who receive this notice likely automatically qualified for Extra Help previously, either through having Medicaid, a Medicare Savings Program, or through receiving Supplemental Security Income. They may be receiving this notice because they are no longer eligible for Medicaid, a Medicare Savings Program, or SSI.
Even though you received this notice, you may still qualify for Extra Help and should apply again for the benefit. The notice should include an application for Extra Help. You can complete this application and mail it to the Social Security Administration, or you can apply online at www.ssa.gov. —Marci
Marci’s Medicare Answers is a service of the Medicare Rights Center found online at www.medicarerights.org.