Skip to Main Content (717) 697-3223

Medicare Open Enrollment: What You Should Know

Medicare Open Enrollment: What You Should Know

Newsflash!  If you are enrolled in Medicare, the new health insurance exchanges DO NOT AFFECT YOU. You will continue to have the same benefits that you have had, and you DO NOT have to replace your Medicare coverage with coverage through the marketplace.  That said, Medicare’s open enrollment period is from October 15th– December 7th.  What is the purpose of the Medicare enrollment period? Although Medicare is a federal program, benefits are available through a number of different providers.  You do not have to re-enroll in Medicare every year, but you do have the option to change your Medicare plan if you want to.  The annual open enrollment period is your opportunity to make any desired changes

Original Medicare coverage is comprised of three parts:  hospital insurance (Part A), medical insurance (Part B), and prescription insurance (Part D).  The federal government manages all three parts of original Medicare.  Medicare coverage is also available through Medicare Advantage plans.  These plans are managed by private insurance companies and are sometimes referred to as Part C plans.  Medicare Advantage plans include both Part A and Part B benefits, usually include Part D benefits, and may offer supplemental coverage as well. All benefits are combined into one policy. Individual insurance companies each may offer several types of advantage plans that have differences in the deductibles and copays, or in the specifics of the extra benefits offered.

If you are choosing coverage for the first time, or thinking about changing your Medicare plan, visit for information about the types of plans that are available in our area, as well as general information about Medicare.  This site recommends 8 factors to consider when choosing or changing your coverage:

  • Coverage- Are the services you need included in the plan?
  • Additional health insurance- Do you have other health insurance, either privately or through an employer/retirement plan?  Ask questions about how this coverage works with Medicare.
  • Costs- Consider deductibles, copays, premiums, yearly limits on payments for services.
  • Medical providers- Does your physician participate in the plan you are considering?  Must you choose providers from a network, and are referrals required?  Think about specialists you may need for any specific health conditions you have, as well as hospital services.  How many choices of providers will you have?  Do you prefer large or small physician practices?
  • Medications- Everyone should have a drug plan, even if you aren’t taking any medications.  If you do not sign up when you are initially eligible, or have other “credible” prescription drug coverage, you may face a late enrollment penalty which could significantly increase your costs.  Everyone also should review their Part D plan every year.  Your medications may have changed, or your current plan’s coverage of certain medications may have changed.  If you do nothing else, at least review this portion of your coverage to be sure that you have the plan best suited for your specific medication regimen.
  • Quality of care- Are you satisfied with the physical care from providers in your plan, as well as the customer service from the plan itself?
  • Convenience- Consider the location and hours of the providers that you will use.  Do you want the availability of a mail order pharmacy?
  • Travel- If you enjoy traveling either within or outside of the United States, or if you reside in different areas of the country at different times of the year, choose coverage that will travel with you.

Does the process of enrolling in or changing your Medicare plan seem daunting?  The APPRISE program, run by county Offices of Aging, provides counselors who are trained to assist you with your Medicare questions.  Visit our website www.keystoneelderlaw and check out the “resources” tab for educational brochures about Medicare and a variety of other topics.   If you’ve been wondering whether or not you have the most appropriate Medicare plan for your health, ACT NOW, or you may have to wait until next fall for a chance to improve your service and benefits.

Karen Kaslow, RN

Elder Care Coordinator

Keystone Elder Law P.C.