Home Long-Term Care Medicare Open Enrollment: A Guide for Caregivers

Medicare Open Enrollment: A Guide for Caregivers

by EG

medicareMark your calendars and get started early! October 15 to December 7 is the open enrollment period for Medicare beneficiaries to enroll in or change a Medicare Advantage plan. During that time, beneficiaries can also change their choices for Part D (prescription drug) coverage and, under certain circumstances, change Medigap plans.

The information may seem overwhelming, but here are the essentials.

Your care recipient should have received an annual notice in the mail from the companies supplying their coverage. The first few pages of the Annual Notice of Change (ANOC), the thinner booklet, should help answer the following questions:

  • Will the plan premium go up? If it is going up by 10% or higher, you may want to consider alternatives.
  • Will the deductible go up? If the deductible is raised from zero, that’s another sign that you may want to consider alternatives.
  • If your care recipient takes generic drugs, look to see if the company added another “tier” to the generic drugs and how will this affect your care recipient.

If your care recipient is in a Part C/Medicare Advantage/Managed Care plan:

  • Were there unexpected expenses that the plan did not pay? Are these expenses likely to recur? If so, you may consider switching to a Medigap plan with fixed costs.

If your care recipient is in a Medigap plan:

  • Does your recipient have few physician visits, other than routine wellness checks? Do they live in the same area year-round? If so, you may consider a Medicare Advantage plan, which offers lower premiums and possible additional benefits such as vision and hearing assistance.

If you haven’t re-assessed your care recipient’s plan in at least three years, or you have further specific questions:

  • Use the National Council on Aging’s Medicare Mini-Check tool, a four-question online assessment that can recommend next steps. The Medicare Mini-Check also lets you access free professional advice about Open Enrollment from a licensed benefits advisor.
  • Visit the State Health Assistance Insurance Program (SHIP) website or call their toll-free number at 1-877-839-2675. SHIP can help you find a free Medicare counselor in your region. Their office gets busy during the Open Enrollment period, and access may be difficult – so get in touch early, and be patient.
  • Call your local Area Agency on Aging. Ask if they are hosting any public information sessions on Open Enrollment. They’ll usually take questions publicly and privately.
  • Call the Medicare program’s toll-free number at 1-800-633-4227 (1-800-MEDICARE). Try to call during off hours to reduce wait times. Make sure the advisor tells you your care recipient’s “saved drug ID” and “password date.” This information will help you determine whether their drug formulary has changed.

It’s best to reassess your Medicare program every year to see if the benefits you have are working for you.

Leave a Comment


As an Amazon associate, we earn from qualifying purchases. This site also participates in various other affiliate programs, and we may get a commission through purchases made through our links. Please read our complete Disclosures and Privacy Policy for more information.