Medicare Enrollment Now Open

Annual open enrollment for Medicare starts next week, and Oregon’s Senior Health Insurance Benefits Assistance (SHIBA) Program is available to help. Medicare is health insurance for people 65 years or older or younger than 65 with Social Security Disability Income. People living in Oregon who are 65 years or older may be eligible to sign up and find health insurance that best meets their needs. Medicare covers many medical costs, including visits to the doctor, prescription medications, and preventive care, such as mammograms, colonoscopies, diabetes, and blood pressure screenings.

Medicare annual enrollment runs Oct. 15 through Dec. 7, 2016. Any Medicare Advantage (MA) or prescription drug plan (Part D) changes must be made between these dates so that coverage begins without interruption on Jan. 1, 2017. Those who are late to enroll may face a lifetime of premium penalties. “It is important to compare Medicare Advantage and prescription drug plans every year,” SHIBA Program Coordinator Lisa Emerson said. “Plans change year to year, as do people’s individual health care needs. People could potentially save money by shopping for a new plan.”

SHIBA provides free insurance counseling to explain how the Medicare program works, additional insurance options that work with Medicare, and help with reducing out-of-pocket costs. SHIBA staff members, along with over 200 certified counselors, serve many of Oregon’s more than 760,000 Medicare beneficiaries to help them understand their Medicare benefits and enrollment options. Free, unbiased, one-on-one assistance is available by calling 1-800-722-4134 (toll-free) or visiting OregonSHIBA.org.

SHIBA counselors help beneficiaries compare plans and enroll by using the plan finder tool found online at www.medicare.gov/find-a-plan. Beneficiaries and their families can also choose to use this tool to compare plans and enroll on their own.

Tips from SHIBA to prepare for Medicare Open Enrollment:

Review your plan notice. Be sure to read any notices from your Medicare plan about changes for next year, especially your Annual Notice of Change letter.

Think about what matters most to you. Medicare health and drug plans change each year and so can your health needs. Do you need a new primary care doctor? Does your network include the specialist you want for an upcoming surgery? Is your new medication covered by your current plan? Does another plan offer the same value at a lower cost? Take stock of your health status and determine if you need to make a change.

Find out if you qualify for help paying for your Medicare. Learn about programs in your state to help with the costs of Medicare premiums, your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, co-insurance and co-payments, and Medicare prescription drug coverage costs. You can do this by visiting Medicare.gov or making an appointment with a local certified counselor.

Tips from SHIBA when comparing health insurance plans:

Find your insurance cards. You may need your red, white, and blue Medicare card to review benefit details or enroll in a new plan. If you have a Medicare Advantage or prescription drug plan, you may also need that card.

Update your list of prescription drugs. Check with your doctor to make sure you understand each prescription. Is a generic available? Can you eliminate unneeded medications? Based on your list, do you have the right plan?

Use the Medicare.gov plan finder. The plan finder uses your prescription list to compare prescription drug and Medicare Advantage health plans in your area. Not all companies cover the same drugs so it’s important to have a complete list of your medications and dosages when using this tool.

Contact your doctor, hospital, and pharmacy before making changes. Not all health and drug plans contract or work with the same providers. If you switch plans, make sure you understand which providers you can see for the best price.

Apply for help with drug costs. If you have limited income and assets, you may qualify for extra help with prescription drug costs. SHIBA counselors can help you apply for this benefit through Social Security.

SHIBA also publishes an annual Medicare guide, which will be available online this month and in print in mid-November.