Medicare fall enrollment opens Oct. 15. Here's what is new this year.
Whether you have traditional Medicare with a supplement to cover out-of-pocket costs plus a stand-alone drug plan, or a Medicare Advantage plan that wraps coverage together in one package, there are always small tweaks to plans that are worth reviewing. Plans may change which brands of drugs are covered, or which doctors are in-network, and you don't want to discover that next year when it's too late to switch.
Wading through the many plan options and features that become available every year is confusing no matter how much you know about insurance -- and the relentless advertising by eager Medicare Advantage plans make it more so -- but doing your research can pay off. This year, analysts say, people with Medicare should pay particular attention to:
-- A change to how some plans will cover insulin.
-- Whether you may qualify for financial assistance due to the pandemic-caused economic downturn.
"It's gotten more complicated to be a Medicare beneficiary," said
Beginning in January, Part D prescription medication plans, which are purchased by people who have traditional Medicare, will be allowed -- not required -- to cap the monthly copay for insulin at
In
The change could be a money-saver for people who use insulin to treat Type 1 or Type 2 diabetes. Insulin costs for seniors who do not receive federal subsidies to help with medication expenses shot up 79% between 2007 and 2017, to
But it's important to consider the total cost of a drug plan before making changes, Cubanski said. Plans allowed to participate in the insulin copay program are "enhanced" plans, which offer more generous benefits, but also typically have more costly monthly premiums. If you take other medications, check that they are also covered by the plan. If they're not, the amount saved on insulin could easily be consumed by other drug expenses.
Fall enrollment is a great time for everyone to check whether they are eligible for help -- regardless of whether their income has been affected by the pandemic, she said.
There are several Medicare Savings Programs that help cover premium, drug, and health-care costs for people based on their income and assets.
The Qualified Medicare Beneficiary program, for instance, offers the highest level of assistance and is designed for individuals with a monthly income of no more than
"A lot of people are eligible for this and don't realize it," Murdoch said. "Especially now, when people are going through various hardships, [these programs] can be really helpful."
If you typically visit state aging offices or other enrollment support organizations for help reviewing coverage options, Medicare enrollment specialists say it's a good idea to give yourself extra time this year. Many of the in-person support services that seniors rely on are going virtual because of the pandemic.
"At this point, we are only doing virtual and phone assistance," Natasha Alagarasan, a spokesperson for the
At the
"We are trying to meet our consumers where they are, asking what technologies they have and what their comfort level is," said
So far, the group has found success with the videoconference program Zoom. The group mails enrollment support materials to clients' homes and encourages them to have handy any documents sent by their current insurer, so everyone can look at the same paperwork while reviewing coverage options together online.
"For the folks who do enjoy looking someone in the eye, we acknowledge that's going to be difficult, but we hope people will be able to adapt," Chenoweth said.
Get help with Medicare enrollment:
-- Pennsylvania APPRISE: 800-783-7067, or www.aging.pa.gov/aging-services/medicare-counseling
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-- CARIE: 800-356-3606, or www.carie.org/
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