Medicare’s annual open enrollment begins October 15th and ends on December 7th. There are many changes that will go into effect on January 1, 2020. If you are enrolled in Medicare, it is important to review your current coverage and determine whether to make adjustments.
Open enrollment is the period of time each year when people currently enrolled in Medicare can:
- Switch from traditional Medicare to Medicare Advantage plans, and vice versa.
- Add, drop or switch their Part D prescription coverage.
When examining your options for 2020, you want to consider:
Cost of your medical plan
People enrolled in Traditional Medicare (Parts A & B) with a Medicare Supplemental policy (commonly called “Medigap”), can expect predictable costs for medical care including their annual deductibles and insurance premiums.
Those enrolled in Medicare Advantage Plans (Part C), however, will have variable costs depending on the plan they select, the premium, co-pays, and co-insurance. Medicare Advantage plans are regulated on the national level, but the benefits are determined county by county. Thus, the plans available to you could differ from the plans available to your friend living one county over.
(To understand how Medicare and all its parts work, see my blog posts Decoding the Language of Medicare and Medicare Advantage De-Mystified.
You want to be certain the plan you choose covers both the healthcare you need and your preferred doctors.
Do you travel? Where and how often? Take this into consideration when choosing a plan. You want to be certain you are covered should you have a medical event away from home.
Prescriptions are covered by Medicare Part D. As drug formularies change each year, you will want to check your current Part D insurance to verify it covers both your medications and your pharmacy. Compare your current plan to others to verify you have a plan that best meets your needs and your budget, especially as there are new Part D plans available for next year.
Out-of-pocket costs in Part D plans are increasing.
Once you reach $4,020 in out of pocket drug costs (including deductibles and co-pays), you enter the “Coverage Gap,” which is also called the “Donut Hole.” After you have paid $6,350, you enter “Catastrophic Coverage,” and co-pays are significantly reduced.
The out-of-pocket limit in the “Donut Hole” is increasing to $6,350 which is $1,250 more than 2019.
What is Part D is an article that explains how Medicare Part D works.
Medicare Considers the Donut Hole Closed.
When Medicare Part D plans began in 2006, many people had to pay 100% of their drug costs while in the Coverage Gap. Medicare now considers the gap closed: in 2020, Part D insurance will cover 75% of the cost of your medications, and you will pay 25%.
There are many changes in Medicare Advantage plans.
- Medicare Advantage plans are rolling out new benefits and incentives, many of which are not traditionally associated with medical insurance. An insurance company in my state, for example, is promoting free meal delivery after an inpatient hospital admission, free telemedicine visits, free exercise classes, and up to a $100 reimbursement for completing health and wellness activities.
- Medicare Advantage Plans have the flexibility to provide Value-Based Insurance Design (VBID). The VBID model customizes financial incentives to people who need certain types of health care. A person with a heart condition, for example, may have a 0% co-pay to encourage her to go to doctors’ appointments. Other patients in the same insurance plan who do not have a heart condition might not get this benefit.
- Telemedicine may be an option eliminating the need, in some cases, to travel to your doctor’s office.
- There have been many mergers as hospitals consolidate and insurance companies purchase medical practices. Sometimes, if you want to stay with your doctor, you need to switch to the insurance company which covers your provider.
If you enroll in a Medicare Advantage plan for next year and don’t like it, you have until March 31, 2020 to change to another Medicare Advantage plan or switch to Traditional Medicare.
Changes in Medicare Supplemental (Medigap) plan offerings
Medicare is discontinuing Medigap Plans C and F for new enrollees only. If you are eligible for Medicare before January 1, 2020, you have the option of choosing one of these plans. If you currently have a Plan C or Plan F policy, you can keep it. If you are eligible on or after January 1, 2020, you cannot select Plan C or F, but there are eight other plans from which to choose.
These are just some of the changes expected in Medicare plans for 2020. All of this can be extremely confusing. How do you choose? Medicare has information and tools on its website to help, including:
- Publication 002110: “Choosing a Medigap Policy”
- Publication 12026: “Understanding Medicare Advantage Plans”
To access these publications go to www.medicare.gov, click on “Forms, Help & Resources,” choose “Free Medicare publications” and enter the publication number.
- A comparison of the Medigap plans
- A tool to compare and find Part D prescription and Medicare Advantage Plans
Protect Yourself from Fraud
One thing that hasn’t changed: Open Enrollment is a time ripe for fraud. Medicare will never call you, threaten you, ask for your personal information over the phone, or demand payment or gift cards. Only give out your Medicare number and other personal information if you initiate the call.
This blog is published to provide you with general information only, and is not intended to provide specific or comprehensive advice. Money Care, LLC encourages individuals to seek advice from competent professionals when appropriate.