Medicare Open Enrollment Tips

Are you ready for Medicare Open Enrollment? If not, you need to get ready! Open Enrollment is only October 15 through December 7, and there are penalties for missing the window; it’s worth a few minutes of your time today to prepare yourself. Open Enrollment can be confusing, so we’re sharing seven tips to help you understand what your Medicare options and requirements are.

Open Enrollment Tip 1 — Don’t Just Re-Up but Re-Evaluate

Even if you’re already enrolled in a Medicare health plan, it’s important to understand that the Open Enrollment period is largely about reevaluating your current Medicare Advantage or Part D plan, or both.

The big question you should be asking yourself is, “Do I need to change my plan or should I stay with my current plan?” The answer to that question begins with finding the answers to these related questions:

• Has anything changed in my life?
• Has anything changed in the plan I’m on? 
• Has anything changed in the other plans available to me?

If nothing has changed significantly in any of those three areas, then your best strategy might be to stay with your current plan. Odds are though that at least one of these three things has changed. Take the time to go through the plans, looking for the option that best meets your needs.

Open Enrollment Tip 2 — Check Your Health

When you previously selected Medicare coverage, your health was a major factor. If you experienced a change in health status during the past 12 months, you’ve likely put your insurance plan to use, giving you a chance to evaluate the out-of-pocket costs and the quality of care you received. If it was not satisfactory, you should look for a plan that would offer improvements.

Open Enrollment Tip 3 — Evaluate Cost vs. Benefit

Oftentimes a more expensive plan comes with a wider range of benefits. This may have been appealing if you were thinking, “Better safe than sorry.” But that plan’s monthly payments may have proven to be more of a cost burden than you expected, especially if any of your other expenses have increased. Or, maybe you selected a lower-cost plan and now feel you’re feeling burdened by co-pays. In either case, a plan change may be exactly what you need.

Open Enrollment Tip 4 — Verify That Your Plan Features Match Your Lifestyle

There are measurable cost differences between Original Medicare and Medicare Advantage plans. Medicare Advantage plans (also known as Part C plans) are more affordable, but come with more restrictions, such as being more geographically localized to your home area. If you plan to spend a lot of time away from home (think snowbirds), you may be better off with Original Medicare rather than a Medicare Advantage plan.

Open Enrollment Tip 5 — Look at Prescription Drug Coverage

Many factors influence your choice for prescription drug coverage. These include:

• Choosing no insurance because you feel you can cover the cost of your prescription drugs on your own
• Enrolling in a Part D drug plan 
• Choosing a Medicare Advantage plan that already includes drug coverage 
• Getting your coverage through an employer or via your VA benefits 
• Using a state-based Prescription Assistance Program, if available in your state

Keep in mind that you’re a year older now than when you last evaluated your options. As we age, the likelihood of needing prescription drugs goes up, and often substantially if, for instance, you develop a chronic condition that requires ongoing medication. So, if you are not already covered adequately to meet a changing medical status, use Open Enrollment to fix that.

Open Enrollment Tip 6 — Take a 1-Minute Quiz

Are you still feeling unsure and overwhelmed? Before making any decisions about switching your coverage during Open Enrollment, take this short Medicare Questionnaire, created by The National Council on Aging (NCOA), one of our partners. It gives you advice about how to choose the best plan for your needs, and about whether to change your Medicare plan during Open Enrollment.

Open Enrollment Tip 7 — Beware the Donut Hole!

The “donut hole” is a coverage gap in certain Medicare Prescription Drug Plans that begins after you reach a certain dollar amount for covered drug purchases in a calendar year. This gap can significantly affect your prescription costs. But you can lessen its impact on your wallet by using the FamilyWize Prescription Savings Card. It’s free and anyone can use the card – insured or not. There are no qualifications to use the card, and it can save you an average of 43% off the cost of your prescription medications.

All you have to do is show the FamilyWize card (or app) to your pharmacist the next time you pick up a prescription and ask them to compare the discount offered by the card to the price you would pay otherwise. In many cases, the FamilyWize price proves to be the better deal.

And don’t forget to comparison shop. You can check the price for your prescription at all participating pharmacies in a selected region using our Drug Price Lookup Tool, available on our website or through our app (just search "FamilyWize" in your smartphone's app store). Then you can fill your prescription at the most affordable location.

With a little bit of effort, you can confidently manage your Medicare plan and prescription coverage. Take the time to do your research and prepare – especially during Open Enrollment!