By Dr. Wilson Liu, Primary Care Specialist
It’s that time of the year again. Yes, Thanksgiving is just around the corner, with Christmas and other wonderful cultural holiday season festivities and traditions.
But it’s also that time of the year called Medicare Open Enrollment season.
Medicare Open Enrollment is the annual period of time in which current Medicare enrollees can re-evaluate their Medicare coverage, and decide whether they want to keep or change their current plans.
While not as exciting as getting together with family and friends and feasting, Medicare Open Enrollment season is important because this is the only time of the year that you can select a new Medicare Advantage or Medicare Part D plan and make decisions to get the most out of your Medicare healthcare coverage, including potentially choosing a new primary care physician.
You can also save money, by making sure your favorite physicians are in-network and choosing prescription drug plans that cover your current medications.
This year, as it has been since 2011, open enrollment is from October 15 to December 7, for an effective coverage starting January 1, 2018.
THE SIMPLE BREAKDOWN:
- If you have Medicare Advantage (medical care and prescription drug coverage), you can continue with your current plan, switch to a new Medicare Advantage plan, or drop it and choose traditional Medicare (also called Medicare A & B).
- If you have traditional Medicare, you can join a Medicare Advantage plan.
- If you have traditional Medicare, you can join a Medicare Part D (prescription plan).
- If you already have Medicare Part D, you can change Part D plans.
Please note that if you have Medicare Advantage, you do not need Medicare Part D, as Medicare Advantage includes prescription drug coverage.
If you are already enrolled in Medicare Advantage or Medicare Plan D and don’t want to make changes, you don’t need to do anything during open enrollment. However, be aware that your coverage/benefits could change yearly, so look for “Annual Notices of Change” and “Evidence of Benefits” mailers that health plans send this time of year.
WHAT FACTORS TO CONSIDER:
This is your opportunity to select the primary care physician, and the specialists, that you prefer who will provide you with care for the following year. The hospital you prefer may also be a consideration.
Remember that if you select a Medicare Advantage plan, it will be at least one year before you can change networks, meaning you, your primary care physician, specialists, and the hospital of the network you choose will be in basically a one-year relationship, which could be wonderful, or something you’ll need to tolerate for a year.
Choosing a network with a primary care physician who will be a good fit for you is important. Studies have shown that people value physicians who listen carefully to their concerns, spend necessary time if needed, and value communication.
If you currently have prescription drug coverage through Medicare Advantage or Part D, review your current medications and cross-reference with your plan’s 2018 formulary coverage, as formularies can change year to year. This is important if you have an extensive or expensive prescription list.
In evaluating Plan D programs, be aware that although some Plan D coverage premiums may be more expensive, you may recoup those costs if your expensive medications are covered in their formulary.
It’s Medicare open enrollment time
Choose a plan that suits your individual needs, that gets you the physicians you want to take care of you, and that will cover your prescriptions. Then you’ll have the peace of mind that you’ve made the right decision for you in 2018.
And, before the end of the year, don’t forget to get your influenza vaccine and your annual Medicare wellness exam!
About Dr. Liu
Dr. Wilson Liu has been practicing Family Medicine since 1993. His medical interests including providing care for the entire family including pediatrics, geriatrics, preventive medicine, orthopedics, dermatology, and mental health. In his free time, Dr. Liu enjoys live music, sports, exercise, travel, Japanese culture, gardening, cooking and exploring San Diego. He speaks Taiwanese, basic Japanese, and medical Spanish. To find out more about Dr. Liu or to schedule an appointment visit Tricitymed.org or call 855.222.8262.