Believe it or not, it’s almost that time of year again. Medicare’s Open Enrollment (also known as the Annual Election Period) is just around the corner and it’s time to get ready. From October 15 through December 7, Medicare’s Open Enrollment is main time frame each year you can make a change to your Medicare coverage.
During this time, you can enroll in a Medicare Advantage (MA) plan or Prescription Drug Plan (PDP). If you’re already enrolled in a MA or PDP, you can change your current plan and enroll in a new plan or you can drop your current MA plan and return to Original Medicare. Just remember, you will need to enroll in a PDP to cover your medications if you drop your MA plan. Any of these plan changes that you make during the Medicare Open Enrollment Period are effective January 1.
Even if you’re currently happy with your coverage, it could look very different in 2024. That’s because each year, Medicare Advantage plans and Part D prescription drug plans can change their premiums, deductibles, cost-sharing and some benefits, provider groups they contract with, or discontinue their coverage altogether. It’s important to be aware of how your plan may change, and prepare accordingly.
One place to start, if you’re in a Medicare Advantage and/or Part D plan, is to review your plan’s Annual Notice of Change (ANOC) that explains its changes for 2024. Your plan should have sent this to you by September 30. For example, the Annual Notice of Change would include information such as your premium and copayment, if your plan’s provider network will change, and/or a list of drugs (called a formulary) that will be covered. Again, even if you like your current plan, review your plan’s changes for 2024 and compare other options to determine which 2024 plans have the coverage that best meets your needs.
Here are some tips to prepare for Medicare’s upcoming Open Enrollment:
- Be ready with a list of all your health care conditions, prescription needs, and desired/necessary providers when you review your options.
- Make a note of any changes to income that might help you qualify for extra help with drug costs or Medicare co-pays.
- Watch your email and mail for important notices from Medicare, Social Security, and your current insurance plans. Read them carefully to be sure they are legitimate notices, and not private plan marketing junk mail.
- Review the 2024 Medicare & You handbook. The handbook is available online in English, Spanish, Chinese, Korean and Vietnamese. It’s also available in large print, braille, audio format and as an e-book. You can also order a hardcopy paper handbook by calling 1-800-MEDICARE (1-800-633-4227).
- If you are considering private plans for your coverage, rather than the universally accepted traditional Medicare program, be sure to review plan options on Medicare’s website.
- Finally, there is help available to navigate these decisions from your State Health Insurance Assistance Program (SHIP). Find contact information for your SHIP program at https://www.shiphelp.org/ (In CA known as HICAP – the Health Insurance Counseling and Advocacy Program, at (800) 434-0222.)
Watch For Fraud And Marketing Misconduct
Also, make sure to watch for enrollment fraud and forceful and/or misleading marketing during this time of year. Insurance companies and their agents can try to reach you, creating a flood of marketing information through television commercials, radio ads, events, mailings, phone calls, and texts. Yet the government has rules on what they can and cannot do. Knowing the rules and red flags can help you prevent fraud and make the best choices for yourself during Open Enrollment.
Keep these simple do’s and don’ts in mind. Medicare Advantage plans and their agents and insurance brokers cannot:
- Call or email you if you are not enrolled in the company’s plan.
- Call or email you if you have asked them to stop – even if you are enrolled in their plan.
- Visit your home without an appointment.
- Sell you a plan or set up a sales appointment with you while at an educational event. If you share your contact information at an event like this, this often permits plans to contact you later. However, this permission to contact you expires after 12 months.
- Use the Medicare name or logo or imply that they represent Medicare.
- Approach you in public spaces, like a mall or parking lot.
On the other hand, private health plans and their representatives/agents can and must:
- Explain how enrolling in a new plan will affect your current coverage.
- Check that your providers and pharmacies are in the plan’s network before enrolling you.
- Tell you which companies they represent and whether they sell all plans available in your area.
- Schedule an appointment with you no sooner than 48 hours after you agree to the scope of the appointment.
Also, watch for these potential marketing violation red flags:
- No one should make you feel pressured or rushed to enroll in their plan.
- No one should make you feel that you could lose your Medicare benefits if you don’t enroll in their plan.
- No one should ask for your Medicare or Social Security numbers just to provide you with information.
- No one should make a cold call to ask for your Medicare or Social Security information.
If you come across any red flags or suspected fraud, please report it to our California Senior Medicare Patrol (SMP) at 1-855-613-7080. For more a good reminder and summary of what plans and insurance agents can and cannot do in terms of marketing, see our new Novella, “Older Adults & Medicare Health Plans” available in English and Spanish.