Medicare Part D Open Enrollment is here

What an amazing summer we have had! Now the weather has turned cooler and autumn is definitely in the air. As we plunge into all of the activities of this season, it is important to remember the Part D Open Enrollment Period (OEP) will soon be here. Once again, the Open Enrollment Period will be scheduled between October 15 and December 7. The Part D Open Enrollment Period is the annual opportunity for Medicare beneficiaries with Part D plans to review and possibly change their coverage. You are eligible for Part D if you have Medicare Part A and/or Part B.

Medicare contracts with private companies that offer a variety of Part D plans. Remember, even though you may be very pleased with the plan you have currently, you will want to take advantage of this enrollment period. The reason is that the companies that provide Part D plans have the right to make numerous changes each year. These include:

the specific medications that they are going to cover in the upcoming year

the monthly premium they are going charge

the deductible they will require before the initial coverage period

the tier level to which they assign a medication

what pharmacies are going to be in-network and what restrictions they may want to put a medication.

Additionally, there may be new plans offered. In 2018 the least expensive monthly premium was $20.80 per month. In 2019, two plans offered a less expensive premium.

This year in Alaska there are 22 plans available from which to choose. The plan that is best for you is the plan that covers your specific medications and works with your choice of pharmacies at the lowest cost. Medicare counselors across the state of Alaska are gearing up to assist beneficiaries who want to review their coverage and see what is available for 2020.

If you have a Part D plan, the company that is providing your plan will be sending you a notice that explains the changes that they are making to your plan. This is called the Annual Notice of Change (ANOC) and should arrive in your mailbox in the middle of September. You will want to read it carefully to ascertain if your medications will continue to be covered by the plan and if there will be changes in the costs such as the monthly premium and the annual deductible. If you choose to change plans, your new coverage will become effective on January 1, 2020.

If you have neglected to sign up for Part D in the past, but now would like to enroll in a plan, this is your opportunity. You will likely have to pay a late enrollment penalty in addition to your Part D premium each month. The Late Enrollment Penalty (LEP) is calculated on each month that you were eligible for Part D, but did not enroll and did not have other prescription coverage that was creditable (as good as Medicare’s). The penalty is 1% of the national base beneficiary premium ($33.19 in 2019) or about $.33 each month or about $3.96 per year.

Ask for Extra Help

When you schedule your Part D review, ask if you are eligible for the Extra Help program. The Extra Help Program offers assistance in paying for Part D coverage if you meet the income and asset qualifications. Your Medicare counselor can screen you and assist you in applying for this program. If you qualify, the program will help pay for the monthly premium, the deductible, and the co-pays and co-insurances associated your plan.

Beware these approaches

The Center for Medicare and Medicaid Services has set specific rules that companies offering Part D plans must follow when promoting their plans. These rules are designed to prevent marketing fraud. Some of the things agents cannot do are: call you if you have not given them permission, visit you in your home without an invitation, provide gifts and prizes with a value greater than $15 to entice you to enroll, market their plans at educational events or health care settings or imply that they represent Medicare. They cannot use any terms like “Medicare-endorsed” or suggest that their plan is preferred by Medicare. They must follow all federal and state consumer protection laws for telemarketing, and the National Do-Not- Call Registry. If you experience any of these activities, please contact the Medicare Information Office and report it.

To schedule a Part D review, or if you have any questions about your Medicare benefits, you can contact the Medicare Information Office at 1-800-478-6065 toll-free in Alaska or for Anchorage residents, (907) 269-3680.

Nila Morgan is a Certified Medicare Counselor who works at the Anchorage Senior Activity Center.

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Nila Morgan is a Certified Medicare Counselor who works at the Anchorage Senior Activity Center.