It’s time to find the best fit for Medicare Advantage and Part D prescription drug plans

Oct. 15--Open enrollment begins Sunday for older and disabled adults who want to shop for Medicare prescription drug or managed-care plans for 2018.

Enrollment begins every Oct. 15 and will continue through Dec. 7. Changes are effective Jan. 1.

The Medicare Part D prescription drug plans and Medicare Advantage managed-care plans are available for everyone covered by Medicare, the federal health insurance program for people 65 or older and some younger disabled Americans.

Enrollees should review their coverage and make sure they still have the best plan to meet their current needs because plans and prices change yearly, said Chris Reeg, director of the Ohio Department of Insurance's Ohio Senior Health Insurance Information Program (OSHIP).

"A lot of folks do stay with the same plans year after year and they may not be the best," she said. "Just because something was the best plan for 2017, it may not be the best plan for 2018."

Similarly, spouses need to review their plans individually and often have to pick different providers, Reeg said.

"Sometimes there's a substantial cost difference" because it depends on the health of the individual and the prescription drugs taken, she said.

More than 2.2 million Ohio residents covered by Medicare can select from among 23 Medicare prescription drug plans, also known as Medicare Part D plans.

Nationally, enrollment in Medicare Advantage is projected to reach an all-time high of 20.4 million enrollees in 2018, an increase of 1.7 million or 9 percent from 18.7 million this year, according to the Centers for Medicare and Medicaid Services.

In Summit County, there are 41 Medicare Advantage managed-care plans available that provide help paying for doctor visits, hospital stays and other medical services. All but four include prescription drug coverage.

The Medicare Part D plans are offered statewide; the Medicare Advantage plans vary county by county.

The federal government contracts with private insurance companies to provide drug and/or medical coverage to Medicare recipients who sign up for the plans. Everyone but the poorest enrollees pays a portion of the monthly premium; the government picks up the rest.

Francine Chuchanis, a Medicare ombudsman for the Direction Home Akron Canton Area Agency on Aging, reviews the Medicare Advantage plans offered in Summit County yearly.

This year, there have been minimal changes in premiums and coverage, she said. Some plans have increased deductibles, while others have decreased them.

"We have seen years where averages have gone up and down, but this year seems to be relatively stable," Chuchanis said.

In Summit County, 13 Medicare Advantage plans have no monthly premiums for enrollees; three of those plans do not offer prescription drug coverage.

The cheapest monthly premium for a Part D prescription drug plan in Ohio is $12.60 a month from EnvisionRX Plus.

However, Chuchanis warns against simply choosing the cheapest plans without looking at other factors.

Consumers also need to look at out-of-pocket costs for services they use most, as well as costs for their prescription drugs, she said.

Both OSHIP and Direction Home offer workshops and phone consultations to help seniors research their choices.

"A growing demographic of Medicare patients are using the internet to gain information, but the majority are still a little gun shy or they want reassurance," Reeg said. "Our job is to provide them factual information about the plans so they can make an educated decision in choosing their best plan during the year."

Once seniors narrow down their choices, they also can talk to a representative from the company, who is usually on commission, Chuchanis said.

She suggests seniors check with their doctors to make sure their health-care providers will be included in the plan they want. Confirm the information with the insurance company by calling or visiting the insurer's website.

Also, consumers should use Medicare's quality star ratings, Chuchanis said. The ratings help people with Medicare, their families and their caregivers compare the quality of health and drug plans being offered. Managed-care and drug plans are given a rating on a 1 to 5 star scale, with 1 star representing poor performance and 5 stars representing excellent performance.

Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

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