This content is provided courtesy of USAA.
If you have Medicare Advantage or a Medicare Prescription Drug Plan, it's time for your plan's annual checkup.
Each year, Oct. 15-Dec. 7 is the window to make changes to Medicare Advantage or Medicare Prescription Drug coverage. With health care expenses steadily rising, the enrollment period allows you to evaluate and change your current plan to manage costs more wisely.
Changes You Could Make
Here's what you can change during open enrollment.
| Medicare vs. Medicare Advantage Plan | Drug Coverage |
| Change from original Medicare to a Medicare Advantage plan | Switch from a Medicare Advantage plan that doesn't offer prescription drug coverage to a Medicare Advantage plan that offers drug coverage |
| Change from a Medicare Advantage plan back to original Medicare | Switch from a Medicare Advantage plan that offers prescription drug coverage to a Medicare Advantage plan that doesn't offer drug coverage |
| Switch from one Medicare Advantage plan to another Medicare Advantage plan | Join a Medicare Prescription Drug Plan |
| Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan | |
| Drop your Medicare prescription drug coverage completely |
The Clock Is Ticking
Two Medicare options stand out due to their potential for providing financial relief — prescription drug coverage (Part D) and Medicare Advantage (Part C) plans.
Prescription Drug Plans
Medicare participants can enroll in a Prescription Drug Plan, switch plans, switch plan providers or drop their coverage altogether. Private insurers offer these basic Prescription Drug Plans for premiums that averaged about $30 per month in 2013, according to the U.S. Department of Health and Human Services.
Like other parts of Medicare, Prescription Drug Plans may require participants to pay a share of their expenses through deductibles and co-payments, while offering valuable protection from catastrophic expenses. If you don't already have prescription drug benefits from another plan — such as an employer's retiree medical program or VA benefits — you might want to consider the Medicare option.
As you compare plans, here are some key questions to ask:
- What are the costs? Premiums, deductibles and co-payments vary by plan. It's not critical to find the lowest premium, but make sure the one you pay is competitive.
- Are my medicines covered? Each drug plan has a formulary — a list of covered medicines. Make sure your drugs are on the list, and ask if there are any special rules for filling a prescription.
- Does my pharmacy participate? Make sure the plan is paired with pharmacies in your area, and ask about options for receiving medicine by mail.
- Does my Medicare Advantage plan include a Prescription Drug Plan? If you choose to enroll in a Medicare Advantage plan, many plans offered by private insurers include Medicare Part D.
Medicare Advantage (Part C)
These plans offer Medicare-approved coverage that private companies administer. Coverage includes hospital (Part A) and medical (Part B) benefits. Many plans go further by including vision, dental, hearing and wellness benefits.
If you miss the open enrollment window, you may have another shot at making a change: You can switch to a 5-star Medicare Advantage plan at any time during the year — but you can only do it once.
The star ratings, which reflect more than 50 performance measures including satisfaction surveys, can be found at medicare.gov/find-a-plan.
As you research options, ask yourself these questions:
- Are drug benefits available? Some plans cover prescription drugs, making them an all-in-one health solution.
- How is the plan structured? Medicare Advantage plans can be structured in a variety of ways, including as health maintenance organizations or preferred provider organizations.
- What are the costs? Compare premiums, deductibles and co-payments, keeping in mind that you're paying for quality service.
Getting Started
Follow these steps to make the most of this year's open enrollment.
Learn more. The U.S. government provides a wealth of information about Medicare.
Don't wait. The enrollment window opens Oct. 15. The sooner you start, the more time you'll have to make a decision without feeling pressure.
| If You Want to... | Your Enrollment Period is... |
| Enroll in or change Part D prescription drug coverage | Oct. 15 - Dec. 7 |
| Enroll in or change Medicare Advantage | Oct. 15 - Dec. 7 |
| Switch back to original Medicare | Until Feb. 14 to get Part D plan |
| Switch to a 5-Star Medicare Advantage or drug plan from another plan | Anytime from Dec. 8 to Nov. 30 during the year, but only once a year |
