Medicare Open Enrollment Ends 12/7: Tips for Making Plan Choices

Your Daily News Guide to Medicare Part II: Open enrollment ends Dec. 7 

Seniors need to make their choices about changes in Medicare Advantage of Part D drug plans coverage during open enrollment.

BY PHYLLIS FURMAN / NEW YORK DAILY NEWS; SUNDAY, NOVEMBER 10, 2013, 6:00 PM

 

The days are getting shorter - and for 50 million Medicare beneficiaries that means the deadline for open enrollment, Dec. 7, is getting closer.

 

If you haven't done so yet, now is the time to decide whether to make changes to your Medicare Advantage or Part D prescription drug plans.

 

Sifting through plans and understanding the complicated rules of Medicare is always a challenge, but this year there is an added layer of confusion.

 

The recent launch of the Obamacare health care exchanges has many wondering how these new insurance marketplaces will affect their benefits.

 

The answer: Not a bit.

 

Seniors and others enrolled in Medicare will continue to receive their health coverage through Medicare - not through the exchanges.

No matter how you get Medicare, whether it be through Original Medicare or a Medicare Advantage plan, you'll still have the same benefits and you won't have to make any changes.

 

If you are enrolled in Medicare, you have complied with the health law's mandate requiring most individuals to have health insurance.

"If you have Medicare, that's your source of health insurance," said Nicole Duritz, vice president, health and family at AARP.

 

But that doesn't mean you should sit back and chill.

 

As the deadline for open enrollment approaches, there's still work to be done - and we're here to help.

 

Our Daily News Guide to Medicare Part II will give you the information you need to help you make the right decisions. It will clear up some common misconceptions and tell you where to go for free help.

 

(Part I can be found online at nydailynews.com/life-style/health/guide-medicare-review-open-enrollment).

 

First, you should be aware of some news.

 

Premiums for Medicare Part B, which covers doctor visits, outpatient hospital services and other items, will be $104.90 in 2014, the same as in 2013. The Medicare Part B deductible will also remain unchanged at $147.

 

"The good news is Part B premiums are not going up," said Joe Baker, president of Medicare Rights Center, a nonprofit consumer service organization that provides counseling and education.

 

"The primary reason is the cost savings that were in the Affordable Care Act. Those savings are being passed along to Medicare beneficiaries."

 

But in a negative development for some, insurance companies who sell Medicare Advantage plans have lately been dropping doctors to cut costs.

 

"We've been getting calls from people who are getting notices saying their provider is no longer in the network," Baker said.

That means if you have a Medicare Advantage plan, you have to be especially careful this year to see if your health care providers are still in your plan.

 

If not, this may be the time to switch to another Medicare Advantage plan or to go back to Original Medicare.

 

In general, when looking at your plan or considering another, ask some important questions: How much will you have to pay for premiums, deductibles, doctor visits or hospital stays? Will your doctors accept the coverage? Are the pharmacies in the network conveniently located? Does the plan get a high rating?

 

"If you have a health issue, you want to make sure the components that are important to you are available at a fee you can afford," said Medicare beneficiary Carol Konen, a disabled 58-year-old from Huntington, L.I., who has an insurance plan from EmblemHealth.

 

In the end, you may decide to stick with what you have. But you'll have the satisfaction of knowing you did what you could to make sure your insurance meets your health and financial needs for the coming year.

 

Free help is out there. Here's where to find it:

 

MEDICARE: Medicare.gov (800) Medicare

MEDICARE RIGHTS CENTER: Medicarerights.org (800) 333-4114

NEW YORK HEALTH INSURANCE INFORMATION, COUNSELING AND ASSISTANCE PROGRAM (HIICAP): This program provides health insurance counseling and assistance to Medicare beneficiaries. Assistance is available by phone or in person. Call 311 or (212) 341-3978.

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