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David Sayen: Take Advantage of Medicare Open Enrollment

It’s worth it to take the time to review and compare, but you don’t have to do it alone

By David Sayen |

Medicare is stronger than ever, with more benefits, better choices and lower costs to beneficiaries.

David Sayen
David Sayen

Expanded Medicare benefits under the Affordable Care Act continue to be available — including certain free preventive benefits, cancer screenings and an annual wellness visit.

Whether you choose Original Medicare or a Medicare Advantage plan, take advantage of Medicare’s open enrollment period to review cost, coverage or both for next year (2013). Open enrollment begins Oct. 15 and runs through Dec. 7.

» More benefits: Certain preventive benefits, including cancer screenings, are available at no cost to patients when furnished by qualified and participating health professionals. The annual wellness visit allows people to sit down and discuss with their doctor their health-care needs and the best ways to stay healthy.

» Better choices: Medicare will notify beneficiaries about plan performance and use its online Plan Finder to encourage enrollment in quality plans.

» Lower costs: Average premiums for 2013 for prescription drug coverage and Medicare health plans will remain stable. People who are in the “donut hole” in Medicare’s prescription drug benefit will enjoy 53 percent discounts on covered brand-name drugs and 21 percent discounts on generic drugs.

Your health needs change from year to year. And your health plan may change the benefits and costs each year, too. That’s why it’s important to evaluate your Medicare choices regularly. Open enrollment is the one time of year when all people with Medicare can see what new benefits Medicare has to offer and make changes to their coverage.

It’s worth it to take the time to review and compare, but you don’t have to do it alone. Medicare is available to help.

» Visit www.medicare.gov/find-a-plan to compare your current coverage with all of the options that are available in your area, and enroll in a new plan if you decide to make a change.

» Call 800.633.4227 24 hours a day, seven days a week to find out more about your coverage options. TTY users should call 877.486.2048.

» Review the Medicare & You 2013 handbook. It is mailed to people with Medicare in September.

» Get one-on-one help from your State Health Insurance Assistance Program (SHIP). Visit www.medicare.gov/contacts or call 800.MEDICARE to get the phone number for your state.

» If you have limited income and resources, you may be able to get extra help paying your prescription drug coverage costs. For more information, click here or call Social Security at 800.772.1213. TTY users should call 800.325.0778.

If you qualify, you might pay no more than $2.60 for each generic drug and $6.50 for each brand-name drug. The Centers for Medicare & Medicaid Services estimates that more than 2 million people with Medicare may be eligible for the subsidy, but are not currently enrolled to take advantage of these savings.

Even if you were previously turned down for extra help due to income or resource levels, you should reapply. If you qualify, you will get help paying for Medicare prescription drug coverage premiums, co-payments and deductibles. To qualify, you must make less than $16,755 a year (or $22,695 for married couples). Even if your annual income is higher, you still may be able to get some extra help.

Resources include bank accounts, stocks, and bonds, but not your house or car. There’s no cost or obligation to apply for extra help.

— David Sayen is the regional administrator for California, Arizona, Hawaii, Nevada and the Pacific Trust Territories for the U.S. Centers for Medicare & Medicaid Services. For answers to Medicare questions 24/7, call 1.800.633.4227.




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