Four Tips for the Medicare Annual Enrollment Period

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The opportunity to make changes to your Medicare coverage comes every fall during the Medicare Annual Enrollment Period (AEP), which runs October 15 through December 7. Even if you're happy with your Medicare plan, it's a good idea to revisit your coverage options. But what do you need to look for?

Some things to consider when reviewing your Medicare plan include your upcoming medical expenses, prescription drug costs, and access to your preferred physicians, especially if you have medical needs, such as a pre-existing conditions like HIV. Whether you have Original Medicare (Parts A and B) or Medicare Advantage (Part C, which includes Parts A and B), being prepared for AEP is a must. Here are four little-known secrets to make sure you get the right Medicare plan for your needs.

Prescription Drug Coverage

This is one of the easiest places to look for savings. Each September, before AEP begins, your insurance company is required to send an annual notice of change (ANOC) notifying you of major changes to drug prices for the coming year. Be sure to read through the notice and compare it with your current list of prescriptions to find any price increases.

If you see that a drug you take is going to cost more on your current Medicare plan, it's time to find a better deal. A licensed insurance agent can quickly review available plans and their formularies to see if your out-of-pocket drug costs can be reduced.

Medicare Plan Quality

While most Americans continue to enroll in Original Medicare, Medicare Advantage plans are gaining in popularity. Enrollment in Medicare Advantage grew from 18 percent to 31 percent in 17 years, according to a 2016 Kaiser Family Foundation report. And this year, the Centers for Medicare and Medicaid Services (CMS) projects enrollment of 34 percent in 2018.

If you want to know more about the quality of your Medicare Advantage plan, Medicare provides a star-rating system on a scale of 1 to 5, with plans rated from 4.5 to 5 being the best. These ratings come from patients, physicians, and monitoring activities from Medicare.

Medicare Cost Plans (not available everywhere) and prescription drug plans are also given star quality ratings. The pressure is on healthcare providers to give patients quality care, and insurance companies seriously consider the ratings, which are released every fall. In fact, Medicare has designated a special enrollment period to allow consumers a one-time opportunity to enroll in a five-star quality plan (if locally available) anytime during the year without penalty.

If you're interested in switching to a high-rated Medicare Advantage plan, a licensed insurance agent can help you find the right one for you.

LGBT Medicare Issues to Consider

Medicare is obviously a benefit that's not LGBT specific, but some services can affect the population more than the straight community. For example, more LGBT senior individuals and couples face income insecurity. If you need extra help with deductibles, coinsurance, or copayments, talk to a licensed insurance agent to find out more about qualifications. You may also be able to receive help with prescription medications.

For transgender seniors, you can still receive sex-specific procedures even if your Medicare card or other ID shows a different gender identity. Reassignment surgery is covered by Medicare on a case-by-case basis. Health and Human Services (HHS) has yet to issue guidelines for sex reassignment, so you may need legal assistance to ensure access those services.

Know Your Options

The Medicare Annual Enrollment Period is generally the only time you can enroll in or switch Medicare Advantage plans or prescription drug plans. Any changes you make to your Medicare coverage will go into effect January 1.

If you are happy with your Medicare coverage, then you will automatically be re-enrolled in your Medicare plan. However, if you've thought about enrolling in another type of Medicare plan -- or want to just make sure your current plan is still right for you -- AEP is the time to do it.

An agent can help you compare Medicare plans to find the one that best fits your needs and budget during this Medicare Annual Enrollment Period.


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