Attention all seniors on Medicare: It's time to review your drug plan to make sure there's not a cheaper or better one for next year. Eighty percent of beneficiaries on average can save $500 by changing drug plans annually.
Those are the main messages industry observers want Medicare beneficiaries to get — right now. Medicare's annual open enrollment period for changing drug and health plans starts Saturday and continues through Dec. 7, nearly a full month earlier than usual.
Ray Walker, director of the Oklahoma Insurance Department's free Senior Health Insurance Counseling Program (SHIP), recommends seniors every year seek counseling on Medicare Part D, which covers prescription drugs through private insurance companies.
“Medications for many seniors change yearly,” Walker said. “Their doctor may have switched their heart pill or added something for hypertension, and even if their prescriptions are the same, companies can change the drugs they cover from year to year.”
Moreover, a plan's rates and cost structure can go up annually, Walker said.
“It's not unusual for a plan they're paying $50 a month for this year to go up to $150 monthly,” he said.
If seniors don't make changes by Dec. 7, most will be locked into their drug plans for another year, Walker said. Meanwhile, many seniors aren't aware the enrollment period no longer extends to Dec. 31, he said.
With thousands of baby boomers turning 65 this year, the government pushed up enrollment to allow more processing time for Medicare and insurance companies before plans' Jan. 1 effective dates, Walker said. This year, 13 percent of the U.S. population is 65 or older, statistics show.
Finding the best plan
The SHIP program can help beneficiaries find the most cost-effective and best plans by using the plan finder search engine on medicare.gov, Walker said. Counselors enter beneficiaries' information, such as birth date and ZIP code, along with their medications and the pharmacies they like to use to find their best options.
Though most seniors in Oklahoma who carry drug plans choose Part D Medicare insurance, others have Medicare Advantage (MA) health plans that include prescription drug coverage, Walker said. During the Oct. 15 to Dec. 7 enrollment period, counselors can help seniors pick up or drop a Medicare Advantage plan or switch to a new one, he said.
“Seniors in rural areas should be particularly cautious about agents selling them plans that may be attractive because of additional benefits Medicare doesn't cover,” Walker said. “Many of those plans may not have hospitals or physicians located within their community, and traveling to Oklahoma City or Tulsa would be inconvenient or impossible for them.”
Independent consultant Linda Clure underscores Walker's advice for seniors to seek free guidance from trained volunteers.
“There are so many details and nuances, it can be somewhat complicated,” she said. “You can read all you want yourself, but you're not going to risk anything by going for a review.”
To augment SHIP and other efforts to advise seniors, Clure and others this year worked with Areawide Aging Agency to train 30 volunteers on the same counseling offered by the insurance department and 1-800-Medicare.
Areawide Aging employees, Clure said, will set appointments for seniors to meet with volunteers one week in October, a week in November and five work days in December at its offices and other Oklahoma City sites.
In Enid, the North Oklahoma Development Association will offer counseling to seniors across Garfield and seven surrounding counties.
“In our experience, 80 percent of those we counsel save money by changing their plans annually,” said A.J. Shorter, information and assistance specialist.
Last year, the 1,200 seniors that association volunteers enrolled saved an average of $500, he said. “That's $600,000 that stayed in the pockets of seniors in Oklahoma.”
With most seniors dependent on about a $1,000 monthly Social Security benefit, the Medicare drug saving leaves money in their budgets, he said.
“It's important to their lives and the towns they live in,” Shorter said. “Everybody benefits.”
AT A GLANCE
Medicare election period
• Most Medicare beneficiaries can change their drug or health plans only once per year, during Medicare's annual election period. This year, the election period is Oct. 15 to Dec. 7, almost a month earlier than before.
• For free counseling on Medicare prescription drug and health plans, call the Senior Health Insurance Counseling Program (SHIP) at the Oklahoma Insurance Department at (800) 763-2828, 8 a.m. to 5 p.m. weekdays. Counselors can answer questions or set appointments for their office at 3625 NW 56, Suite 100.
• Seniors in Oklahoma, Logan, Cleveland and Canadian counties also may call the Areawide Aging Agency at 943-4344, which this year has trained an additional contingency of volunteers to advise beneficiaries in face-to-face counseling at locations across the metro area.
• On-site counseling also is available in Enid and other outlying areas. Rural Oklahomans may call (800) 211-2116 for Areawide Information and
Extra Help/Low-Income Subsidy
Seniors with annual incomes up to $16,335 ($22,065 for married couples) and up to $12,640 in savings vehicles and property excluding their home ($25,260 for married couples) may qualify for extra help from Medicare to pay prescription costs. For most, costs will be no more than $2.50 for each generic/$6.30 for each brand-name covered drug. Other people pay only a portion of their premiums and deductibles.
When to enroll in Medicare
It's critical you enroll when you turn 65. If you fail to sign up for Part B within a seven-month period (including the month you turn 65 and the three months on either side), you'll face a 10 percent annual penalty on your Medicare insurance for life. To sign up for Medicare, call the Social Security Administration at (800) 772-1213. If you begin drawing Social Security benefits early at age 62, you'll automatically be enrolled in Medicare at age 65. You can defer Part B until you quit working. But if your firm has fewer than 20 employees, you must enroll in Part B because your employer's group insurance may not pay.