NYC Insurance Blog

How Should I prepare for the Medicare Annual Election Period (AEP)?

Did you know that most Medicare beneficiaries can only change their plans at specific times each year? Therefore, the annual enrollment period, also known as the annual election period (runs from 15th October to 7th December), is very important. During this period, you can review your Medicare coverage to ensure you have the best plan for all your medical needs. Thorough research and planning are recommended to prepare well. The following tips can help you prepare for the Medicare annual enrollment period:

I. Check your eligibility

To enroll in the Medicare Advantage plan, you must have Medicare Part A and B. Also, to enroll in Medicare Part D, i.e., the Prescription Drug plan, you must have the Original Medicare and live in the service area. If you fail to meet these requirements, you cannot review and make changes during the AEP.

II. Review your Medicare coverage

Since your medical needs can change with time, reviewing your current coverage is important. Carefully review the services you use and if they are within your budget. Sometimes you can change your Medicare plan to reduce out-of-pocket costs depending on your current healthcare needs.

With Medicare Part A and B, you can sign up for a plan that offers additional services, for example, dental, vision, and hearing. Getting additional health coverage can help you save money in the long run. Typically, Medicare Part A and B do not include prescription drug coverage. Therefore, enrolling in Medicare Part D or Medicare Advantage Prescription Drug plan is prudent if you have a health condition requiring prescription drugs.

It is customary for Medicare Part D (Prescription Drugs plan) carriers and Medicare Advantage carriers to send an Annual Notice of Change letter to beneficiaries. The Annual Notice of Change and Evidence of Coverage (EOC) are crucial documents when reviewing your current Medicare plan. The two documents detail the coverage your current Medicare plan will offer in the new year and if there are any changes in benefits or costs. Since there could be significant changes, carefully review your Medicare coverage to ensure it is the best fit for you next year. If you don’t have prescription drug coverage, you can sign up for Medicare Part D during the annual enrollment period to avoid spending a lot of money buying prescription drugs.

III. Determine how Medicare affects other insurance plans

If you have other medical coverages, for example, retiree benefits, consult a benefits administrator to know how your other insurance plan supplements Medicare. While some insurance plans require you to have Medicare to maintain eligibility, that’s not always the case. You can lose other insurance coverage if you enroll in Medicare Part D or Medicare Advantage. Carefully review and know how Medicare enrollment can affect other insurance plans before joining, switching, or changing your plan.

IV. Get the best deal

Always review your Medicare plan annually to get the best price for your coverage. Typically, Medicare plans vary, and you can save a lot of money through research and comparing prices. To avoid getting overwhelmed while reviewing your plan, create a list of what you like and don’t like about your current coverage. With a list of pros and cons, you can narrow down your choices and eliminate Medicare plans that do not work for you. Use this checklist:

Cost

To get the best deal, ask yourself the following questions:

• What are the deductibles or co-pays?
• What’s the maximum out-of-pocket limit?
• What’s the total cost of medications you take per year?
• Is there a premium for the preferred Medicare plan?

Networks

You need to ask yourself:

• Can you get healthcare from your preferred provider?
• Can you go to the pharmacy you prefer?
• If you travel, are the costs covered?
  

Benefits

To determine how you are benefiting from the plan, ask yourself:

• Can you receive medical cover for all the services you need?
• Do you need prior authorization before accessing any services or medications?
• Do you need any referrals?
• What prescriptions (if any) are covered by the plan?
• Does the plan offer extra benefits like dental or fitness programs?

One of the mistakes people make is waiting until the end of the Annual Enrollment Period (AEP) to decide, only to realize that they cannot get the coverage they want. To effectively review your Medicare options and make the right choice, start by determining your health needs.

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