The Clock is Ticking…for Medicare Open Enrollment

It’s that time of the year again…. Medicare open enrollment. This year open enrollment runs from October 15 until December 7. Below are some points you should consider when deciding which plan is best for you in 2015.

For your Medicare coverage, you have two main choices:

  1. Original Medicare.   With Original Medicare you will want to add a Medicare Supplemental (Medigap) plan and a Part D Prescription Drug Plan, follow this useful guide for testing your pee.  This option is best if you want to pay a set monthly premium and have little or no out-of-pocket cost throughout the year for medical. You will have copays/deductibles with all Part D prescription plans.  It is advantageous for people to choose this type of coverage when they travel outside of Alabama and for people who want to choose their doctors without needing referrals or being restricted to doctors within a plan network.
  • Medicare Advantage Plan.  With Medicare Advantage Plans you combine Part A, Part B and usually Part D coverage and these plans act as a HMO or PPO. Depending on what plans are offered in your area you can have the choice of a plan with no or very low premiums. With Medicare Advantage plans you share the costs of your medical and prescription care. For example, you will have doctor copays and deductibles each time you see your physician or go to the hospital. Each plan has a different maximum out-of-pocket cost so you should carefully compare the Advantage Plans available in your area for the amount you would pay for copays, deductibles and annual maximums.  These plans are best if you are healthy and rarely visit the doctor and you are comfortable knowing you’ll share the costs of all doctor and hospital visits.

Medicare uses information from member satisfaction surveys, plans and healthcare providers to give overall performance star ratings to plans. A plan can get a rating between 1 and 5 stars. A 5-star rating is considered excellent. Medicare has a 5-Star Special Enrollment Period, which allows you to change to a 5-star plan from December 8th – November 30 each year.  This 5-Star Special Enrollment Period will allow you to join a 5-star Medicare Advantage Plan or 5-star Medicare Prescription Drug Plan one time per year when you are outside of the normal open enrollment period. You must have a 5-star plan available in your area to be eligible for a change during the 5-Star Special Enrollment Period. You can see the overall plan star ratings at,-a-plan.

If you are choosing a stand-alone drug plan with original Medicare then be sure to carefully review your prescriptions and choose the best plan that matches your needs. The most expensive plan does not mean it will be the best plan for you.  Be careful when identifying whether you take the brand or generic prescription drug because this can make a significant difference in your drug costs. You can ask your pharmacist or physician for this information.  Some individuals have saved $50 per month just on their Part D premium by switching to a plan that best fits their needs.

You can save hundreds of dollars per year by carefully choosing plans based on your specific health and financial situation. Your best research tool is Medicare’s website where you can input your personal data and they’ll help analyze which plan is best for you.