8 tips for seniors ahead of Medicare open enrollment

Jeanine Skowronski


Jeanine Skowronski

Jeanine Skowronski

Former Head of Content at Policygenius

Jeanine Skowronski is the former head of content at Policygenius in New York City. Her work has been featured in The Wall Street Journal, American Banker Magazine, Newsweek, Business Insider, Yahoo Finance, MSN, CNBC and more.

Published October 8, 2018|3 min read

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Medicare has several different enrollment periods. Open enrollment, also known as the annual enrollment period or annual election period (AEP), is the opportunity for current Medicare beneficiaries to change coverage. It takes place every year from October 15 to December 7 with new plans to go into effect on Jan. 1.

If you're looking to make changes to your 2019 Medicare plan, here are a few things to think about.

1. Know what changes you can make

During open enrollment, existing Medicare beneficiaries can make the following changes:

  • Switch from Medicare Part C to Original Medicare (Medicare Part A and Medicare Part B)

  • Switch to Original Medicare from Medicare Part C

  • Change Medicare Part C plans, also known as Medicare Advantage plans

  • Change Medicare Part D (prescription drug) plans

  • Enroll in a Medicare prescription drug plan when on Original Medicare and in need of one

As a quick overview, Medicare Part A covers inpatient care, while Medicare Part B covers outpatient care. Together, they make up Original Medicare. Medicare Part C is a private alternative to Original Medicare, more commonly referred to as Medicare Advantage and Medicare Part D is prescription drug coverage.

Still confused about all those moving parts? Our partner Via Benefits can help you compare and buy Medicare plans in your area.

2. Review your Annual Notice of Change

Your current Medicare health care provider must send you an annual notice of change by September 30. This notice outlines any changes in coverage, costs or service areas that will go into effect in January. That paperwork is instrumental when it comes to determining whether you should switch plans. If you haven't received your annual notice of change, contact your current health insurer.

3. Double-check your drug formulary

Prescriptions covered by any given Medicare plan vary — and are subject to change. Check your plan's formulary to see if it will still cover the medications you need in the new year. Also check if those meds have changed tiers. The higher the tier, the higher your copay for the prescriptions.

4. Have Medicare Part D? Consider comparison-shopping

Medicare Part D premiums are currently on a two-year decline, with the average price dropping to $32.50 in 2019 from $33.59 in 2018. So, even if you're OK with your prescription drug coverage, it's worth shopping around. You could find a cheaper, but equally robust plan in your area. Learn more about Medicare Part D.

5. Use the free tools at your disposal

You can start comparing plans in your zip code ahead of open enrollment using Medicare's online Plan Finder.

You can call 1-800-MEDICARE (1-800-4227) with general questions. You can also get free counseling from your State Health Insurance Assistance Program (SHIP). Their contact information is available in the 2019 Medicare Handbook.

6. Consider the total cost when comparing plans

Avoid simply opting for the Medicare plan with the lowest premium. Instead, account for all its out-of-pocket costs. On top of your monthly premiums, the big expenses include a plan's deductible (how much you must pay before coverage kicks in) and copays (flat fees or percentages you pay for services or medication).

7. Think big picture

Estimate your current medical expenses as you assess plans. Medicare Part C usually cover services Original Medicare excludes, like vision, dental or prescriptions, so if you need robust coverage, an Advantage Plan might work better for you. Conversely, low-income beneficiaries are eligible for Medicare savings programs, but only when enrolled in Original Medicare.

Set aside ample time to research all of your options and contact health care providers, Medicare or SHIP offices with any applicable questions ahead of open enrollment.

8. You're not necessarily stuck with the plan you pick

The Medicare Advantage disenrollment period runs from January 1 to February 14 each year. It allows Medicare Part C beneficiaires to switch back to Original Medicare and purchase a Medicare Part D plan. In other words, if you enroll in a Medicare Advantage plan and immediately decide you're dissatisfied, you have some time to adjust 2019 coverage.

Medicare beneficiaries can also change coverage if they qualify for a special enrollment period. These periods are generally tied to loss or changes to your current health insurance.

Finally, Medigap plans, which help Original Medicare beneficiaries pay out-of-pocket expenses, are available for purchase all year round. If you're struggling with paying the bills, consider adding this supplemental coverage.

The cost of Medigap plan varies by zip code, too. Here are the states where you'll pay the most (and the least) for Medicare supplement insurance.

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