Review your insurance coverage

It is very important that you review your Medicare coverage every year. Medicare insurance plans can change their costs and coverages every year. Most people can only change their Medicare plans during Fall Open Enrollment which runs from Oct. 15 to Dec. 7 each year.

Even if you are satisfied with your current Medicare coverage, you should check if there is another plan in your area that offers better coverage at a lower price. When choosing a Medicare private drug plan, make sure to look at all costs, not just premium. Another plan may have lower copays, cover more drugs, have fewer restrictions, or offer some coverage during the coverage gap.

If you are considering joining a Medicare Advantage Plan to get drug coverage, remember that you will get all your Medicare benefits from that plan. Look beyond the drug coverage; make sure your preferred providers, hospitals, and pharmacies are in network with copays you can afford.

Each fall, your Medicare private drug plan will send you a notice explaining how your plan's coverage and costs are changing for the next year. Your plan must send you this notice before September 30th. If you do not receive it by this time, call and ask for it.

Find out whether your drugs will be covered next year. Also, determine if your copays will change and whether the plan is adding coverage restrictions that will require your doctor to ask for special permission before the plan will cover your drugs.

If your doctor had to make a special request such as a prior authorization or exception request for your plan to cover a drug this year and you will need the same medication next year, call your plan and find out what you must do to make sure your plan keeps covering your drug. Your doctor may have to make a new request, and she/he may be able to do this before the end of this year to ensure your drug will still be covered next year. If your plan will no longer cover a drug you are taking, your plan must assist you with the exception process or change to another formulary drug before the end of year. If the plan fails to do this, your plan must provide you a 30-day supply of the drug during the first 90 days of the year and send you a notice explaining that the prescription is temporary and that you must file an exception to continue taking it.

Once you have reviewed your current plan, see what other options are available in your area. Assistance is available locally by calling the Lewis County Office for the Aging at 315-376-5313 and asking for an insurance comparison. You can also do this by calling 1-800-MEDICARE or by going online and visiting www.medicare.gov. All year long the Lewis County Office for the Aging and NY Connects (your trusted place to go for free, unbiased information about long term services and supports for people of all ages or with any type of disability) are available to answer your questions about health insurance.

Health Matters is a weekly column centering on providing helpful tips for healthy living on an array of topics. Remember to get approval from your doctor before starting any exercise program or other health regimen. This week's column was provided by Office for the Aging.