Find Answers to Frequently Asked Questions about Enrollment in Medicare
The original article can be found at US NEWS and World Report
The annual Medicare fall open enrollment period, during which people with Medicare can choose or alter their coverage plans, will overlap by several weeks with the open enrollment period for the health insurance marketplaces mandated under the Affordable Care Act, also known as Obamacare.
Finding the right Medicare plan, figuring out deductibles and worrying about the prescription drug “donut hole” can be confusing enough.
According to Paula Muschler, operations manager for Allsup, a private company that advises seniors on their health care options, each year since Obamacare marketplaces launched in 2014, the two open enrollment periods have occurred at the same time, causing some confusion. Medicare beneficiaries, she says, often ask about Obamacare and want to know: “How does this affect me?”
The answer: not much. What follows are some FAQs about Obamacare’s relationship with Medicare and what seniors should consider during the open enrollment period:
Q: Does Obamacare impact my Medicare?
A: Medicare isn’t part of the Obamacare health insurance marketplaces established under the law.
“That’s important for people to understand,” says Juliette Cubanski, a Medicare policy analyst at the nonprofit Kaiser Family Foundation. “[People covered by Medicare] don’t need to worry about the mandates; they don’t need to worry about penalties [for not having health insurance].”
Q: So you’re saying that Obamacare hasn’t changed Medicare at all?
A: Not exactly – because of the health reform law, you’ll get a few more services and save more money.
The ACA requires Medicare to cover certain cancer early-detection screening services, such as mammograms or colonoscopies, with no out-of-pocket charges and without charging you for the Part B coinsurance.
“There are changes made that are actually improvements in benefits,” Cubanski says. “That’s something for people to actually look forward to.”
Seniors now qualify for a free yearly “wellness” visit to a doctor, and health care reform is slowly closing the Medicare prescription drug coverage gap. More on that later.
Q: What’s the open enrollment period?
A: The Medicare open enrollment period, which runs from Oct. 15 through Dec. 7, is the window for the roughly 55 million Medicare recipients to review, tailor or change their policies.
Some Medicare plans during the past year may have been altered or premiums may have risen or fallen, Muschler says. People already enrolled in a Medicare plan can switch their current Medicare Advantage and stand-alone Part D prescription-drug plans or choose to drop their private Medicare plan and go back to Original Medicare to better suit their needs – and the sooner, the better.
“Don’t put it aside, don’t think your plan isn’t changing,” Muschler says. “It might be small changes, but they may be changes you need to pay attention to. Seniors need to act now. Don’t delay it.”
Even if their current Medicare coverage plan is satisfactory, Muschler and others recommend reviewing it anyway to make sure it hasn’t been reworked significantly since last year. A simple switch to a competing plan can save thousands in out-of-pocket costs, including prescription drug co-payments.
Q: I turn 65 in a few months – I’ll be eligible for Medicare, but I haven’t enrolled yet. What should I do during the open enrollment period?
A: People who will become Medicare-eligible soon have a different deadline.
People turning age 65 can sign up for Medicare during a seven-month window that begins as early as three months before the month of their 65th birthday and ends the third month after their birthday month. It’s best not to wait until the last minute.
“The reason you want to start early is you don’t want any [medical coverage] gap,” Muschler says. “You need to review your options and how you will use your coverage.”
Things to consider: Do you have a preferred health care provider or hospital? What are your health needs? Will your particular choice of Medicare coverage travel with you if you move? Are your medications covered and how much will you pay out-of-pocket each time you fill them? Are there restrictions on where you can fill your prescriptions, and if so, are the plan’s preferred pharmacies close to where you live?
Q: Should I sign up for Obamacare instead?
A: Not if you’re enrolled in or eligible for Medicare. The Health Insurance Marketplace under the ACA is designed to help people under the age of 65 access health insurance.
Moreover, it’s illegal for an insurance broker or a health plan to sell you a Marketplace plan if it’s clear that you’re eligible for or are currently covered by Medicare.
Q: Where can I get information about and assistance signing up for Medicare?
A: There are many available resources.
For free personalized counseling services you can reach out to your State Health Insurance Assistance program. Your Local Ship Counselor is TJ Dufresne and she can be reached at 970-468-0295 ext. 120 or by email at firstname.lastname@example.org
The Medicare Rights Center also has a national helpline, which can be reached at: 1-800-333-4114.