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Disability Action Center NW

6 Things to Know about Medicare Fall Open Enrollment for 2013

Fall Open Enrollment is the time of year when you can change your Medicare coverage. You can do this by joining a new Medicare Advantage plan or by joining a new stand-alone prescription drug plan (PDP). You can also return to Original Medicare with or without a stand-alone Part D plan from a Medicare Advantage plan during this time. Listed below are six things to keep in mind while you are deciding on your Medicare coverage for 2013.
1. Fall Open Enrollment occurs from October 15 to December 7 of every year. Learn more about Fall Open Enrollment choices here.   

  • If you enroll in a plan during Fall Open Enrollment, your coverage starts January 1.
  • In most cases, Fall Open Enrollment is the only time you can pick a new Medicare Advantage or Medicare Part D plan.
  • If you have Medicare Advantage, you can also switch to Original Medicare. To get Medicare drug coverage, you can must a stand-alone Part D plan at this time. A Medigap policy will pay original Medicare costs, but you may be limited in your ability to buy a Medigap during the Fall Open Enrollment period, depending on where you live. For more information about purchasing a Medigap please click here.
2. Review your Annual Notice of Change (ANOC).  

  • Even if you like your current Medicare coverage and want to continue with that plan, you should carefully read your ANOC to make sure the plan still features the coverage you like. 
  • Plan can change how they cover your care each year. This means that pharmacy and provider networks can change, costs can change and drugs covered by the plan’s formulary can change.
  • Be aware of your other benefits such as COBRAunion orretiree plans. Consider all your insurance coverage when choosing a plan for next year.
3. Help is out there. 

  • If you want to join a stand-alone prescription drug plan (PDP) , use the Plan Finder tool on Medicare.gov. ThePlan Finder tool compares plans based on the drugs you need, the pharmacy you go to and your drug costs.
  • If you want to join a Medicare Advantage plan, call 800-Medicare to find out what plans are in your area. When you receive the list of plans, check the plan websites to see which best fits your needs.
  • After you have researched a plan online, call the plan itself to confirm what you learned. Make sure your doctors, hospitals and pharmacies are in network, that the plan covers all your drugs, and includes the pharmacies you use. Write down everything about that conversation. In your notes, record the date of the conversation, whom you spoke with, and the outcome of the call. This helps to protect you in case a plan representative gives you misinformation.
  • Call or visit the website of your State Health Insurance Assistance Program or SHIP. Your state SHIP can help you to understand all of your Medicare coverage options.
4. The best way to enroll in a new plan is to call 800-MEDICARE. 

  • Enrolling in a new plan through Medicare is the best way to help protect you if there are problems with enrollment
    . Write down everything about the conversation when you enroll through Medicare. In your notes, record the date of the conversation, whom you spoke with, and any information you were given during the call.
  • Before you enroll with Medicare, confirm all of the details about your new plan with the plan itself.
5. If you are dissatisfied with your Medicare Advantage plan, you can disenroll from that plan and join Original Medicare during the Medicare Advantage Disenrollment Period (MADP).  
  • The MADP is every year from January 1 to February 14.
6. Understand what you will pay for drugs and what new drugs will be covered by Medicare Part D in 2013.
  • Starting January 1, 2013, Medicare Part D will begin covering barbiturates and benzodiazepines. Benzodiazepines are covered as a treatment for all medically necessary conditions. Barbiturates will only be covered in 2013 to treat epilepsy, certain cancers and chronic mental health conditions. Check to make sure the barbiturate or benzodiazepine you take is covered on your drug plan’s formulary. Even if your plan does not cover your drug, your plan should provide you with one 30-daytransition fill at sometime during the first 90 days of the year.
  • Medicare coverage of drugs in the doughnut hole is also changing. In 2013, when someone is in the doughnut hole, they will have greater discounts than in previous years. To learn more about 2013 doughnut hole discounts, please click here.