If you’re satisfied with your current Medicare Part D prescription plan or Medicare Advantage plan, you can keep your coverage as is. However, it’s important to remember that costs and coverage for these private insurance plans can change significantly each year, and companies may enter or exit the market.
Most people don’t pay much attention to the open enrollment period, and that can come at a cost. Beneficiaries can potentially save hundreds or even thousands of dollars by finding a plan that better suits their needs.

That’s why it’s always a good idea to compare your options, especially if your health needs have changed.

When is Medicare Open Enrollment?
Medicare open enrollment runs from October 15 to December 7 each year. Any changes you make will take effect on January 1. This year’s enrollment period is particularly significant, as for the first time, enrollees with Part D or Medicare Advantage plans will benefit from a $2,000 annual out-of-pocket spending cap on covered prescriptions. However, this change may lead insurers to adjust their costs and coverage, so it’s essential to explore your options carefully. If you miss the open enrollment period, you may have limited chances to switch until the next year.

What Changes Can You Make?
If You Have Original Medicare:
• Sign up for a Part D prescription plan or switch to a different one.
• Transition from Original Medicare to a Medicare Advantage plan.

If You Have Medicare Advantage:
• Switch between Medicare Advantage plans.
• Return to Original Medicare and choose a Part D prescription plan.

There’s also a special open enrollment period for Medicare Advantage from January 1 to March 31, allowing for further changes.

How to Prepare for Open Enrollment
If you have Original Medicare, it’s crucial to review your Part D options each year to ensure you’re getting the best coverage. Start by checking your annual notice of change, which outlines any revisions to your costs and coverage. Key steps include:
• Review Your Plan Changes: Check if your prescriptions are still covered and if your premiums or out-of-pocket costs have increased.
• Compare Part D Options: Use the Medicare Plan Finder to explore plans in your area, ensuring they cover all your medications.
• Assess Total Costs: Consider premiums alongside copayments to gauge total expenses for your prescriptions.
• Check Pharmacy Networks: Ensure your preferred pharmacies are included in the plan.
• Understand Coverage Requirements: Be aware of any prerequisites like prior authorization or step therapy.

For those with Medicare Advantage, also review the annual notice of change. Make sure to compare available plans to understand premiums, out-of-pocket costs, and provider networks.

Why Consider Switching?
Switching between Original Medicare and Medicare Advantage can have various implications. Medicare Advantage offers bundled services but may require more authorizations and referrals. Conversely, returning to Original Medicare provides more flexibility in provider choice, but may involve additional premiums for Part D and potentially for a Medigap policy to cover out-of-pocket costs.

Get Help with Your Medicare Decisions
As you prepare for open enrollment, consider reaching out to State Health Insurance Assistance Programs (SHIPs) for one-on-one assistance and educational resources. You can also use Medicare’s Plan Finder or call 800-MEDICARE for help comparing plans.

This open enrollment period is your opportunity to ensure you have the best coverage for your needs in the upcoming year. Don’t miss out on the chance to save money and enhance your healthcare experience!