Medicare Open Enrollment – Make Good Choices & Watch Out for Bad Apples

You get a letter in the mail, telling you about the new law that requires you to get a new health care card. Maybe you get a call offering you big discounts on a new health insurance plan. Or maybe someone comes to your house and says they’re from Medicare, and they need your Medicare number to issue you a new card.

Scammers follow the headlines. It’s Medicare open enrollment time. That means if you have Medicare, you get new choices. It also means you have to keep an eye out for people trying to rip you off. That might be crooks trying to get your Medicare number, financial information or health insurance number. Their goal? To steal your identity or trick you into buying something you don’t need. Or it could be “bad apple” insurance agents trying to sell you a Medicare plan that makes them money and cheats you out of benefits you really need.

Don’t let anyone trick you into making a bad decision. Take the time every year for a “check-up” on your Medicare choices during Open Enrollment. Make sure you talk with your Indian health care provider before making changes.

About Medicare “Open Enrollment”

Medicare offers “open enrollment” every year from October 15 to December 7. People with Medicare can make changes to Medicare Prescription Drug plans (Part D) or Medicare Advantage plans during open enrollment. (See our page on Open Enrollment, also referred to as the Annual Election Period, on our website.)

Your situation may have changed after you signed up for Medicare. Maybe you take different medications. Maybe your doctor told you that you now have diabetes—or another new health problem. Maybe you moved to be closer to your family. Whatever the reason, the plan you signed up for last year may not be the best plan for you now.

Or, maybe you didn’t sign up for a Part D prescription drug plan when you first could. You can switch plans during open enrollment each year or sign up for a new Part D drug plan or Medicare Advantage plan.

For Native American beneficiaries, if you get your medicine from an Indian Health Service (IHS) or tribal pharmacy, chances are you have “creditable coverage.”  That means your prescription drug coverage is as good as Medicare requires. Yet, even if you get your medicine from your Indian health care pharmacy you might still need a Medicare prescription drug plan. The plan may help pay for medicine your Indian health care pharmacy cannot.

If you didn’t sign up for a Part D plan when you were first eligible, you may have to pay a penalty to sign up now. But, if you’re Native American and had “creditable coverage” by your IHS or tribal pharmacy, that penalty may be waived.

Part A & B Changes Come Later

Medicare offers another enrollment period between January 1 – March 31 for Part A (hospital) and Part B (outpatient). So, if you didn’t sign up for Part A or Part B when you were first eligible there is still another chance. You might have to pay an extra fee for enrolling late. Some people might qualify for special exceptions.

Things to Consider When Choosing a Plan

1. The type of coverage you need. Does the plan let you see the doctors you want and go to the hospital you want? Does the drug plan cover the medicines you now take?

2. The cost of the plan. Prices are different. Compare costs. Find out if you can get help paying for the plan if you have a low income through the Part D Extra Help program, or if you’re a Native American elder, from your tribe.

3. The location. Can you go to the pharmacy you like? For Native American elders, if you plan to use providers outside of the Indian Health System, are they close to your home?

You are not alone. Get help from family, Indian health care providers, from the Medicare website or from your local Health Insurance Counseling and Advocacy Program (HICAP).

How to Protect Yourself during Open Season

Take a minute to stop and think: Do you really have to get a new health care card? Is that cheap insurance a good deal? Is that “government official” really from the government? The answer to all three is almost always: No.

Don’t let someone push you to make a decision right away. Take your time. Before you share your information, ask people you trust for help. Talk to your friends and family, check with your Indian health benefits coordinator if you’re a Native American elder, and do some research.

Medicare Matters to Elders & Our Communities

Medicare is health insurance for elders that offers peace of mind and protection. It saves you.

For Native American elders,signing up for Medicare doesn’t take away your right to get care from your Indian health care provider. You can still use your IHS or Tribal provider or go to a non-Indian health care provider who takes Medicare. They will all bill Medicare for you.

When you have Medicare and go to your Indian hospital or clinic, Medicare insurance helps pay. You help your Indian health provider and your tribe save money. That money can be used for the health needs of your family and friends.

We need you to help preserve and protect this precious resource. We need you to help protect our communities and your neighbors.

If you think someone is trying to scam you, report it. Then pass it on. Tell your friends and people in your community.

Report scams, or bad agents to your California Senior Medicare Patrol. Call us at: 855-613-7080. SMPs help protect elders and communities and prevent Medicare fraud.

This article was supported in part by grant No. 90SM0012 from the Administration on Aging (AoA), Administration for Community Living (ACL), U.S. Department of Health and Human Services (DHHS).