Navigating Medicare Open Enrollment: What You Need to Know This Season

ME: Auntie Kay...have you signed up for your Medicare again this year???

Auntie Kay: Huh?

ME: Auntie Kay....we are in October you have to re-up your Medicare plan. Did your current plan send you something in the mail about renewal?

Auntie Kay: Probably.....the broker will handle that.

ME: Well have you called them recently?

Auntie Kay: Ehhhhh

ME: Sigh!!!

Here's what I recommended that my aunt do. She should review the updated plan documents that were sent to her in the mail EVEN if she would like to stay with her current plan. I recommend the same for you.

Medicare Annual Open Enrollment: October 15 through December 7

Every year, open enrollment gives you the opportunity to review and change your health and prescription drug coverage to ensure it still fits your health needs and budget.  You can switch between Original Medicare and Medicare Advantage, change Advantage plans, or enroll in, switch, or drop a Medicare Part D prescription drug plan.  I want my Auntie Kay to take advantage of this window. Any changes you make take effect on January 1 of the upcoming year. I recommend re-evaluating your plan and other options during this time, even if you are happy with your current plan. The thing is premiums, copays, doctor networks, and covered drug lists (formularies) frequently shift from year to year. So you should stay in the know.

Getting ready is straightforward and can save you hundreds of dollars in out-of-pocket costs. In the month of September,  you will be mailed a "Plan Annual Notice of Change" (ANOC) which outlines every cost and benefit update for the coming year.  Don't be like my aunt and throw this in the trash. Review it. 

Next, head to Medicare.gov and click on the "Find Plans" tool to compare local options side by side. Have a current list of all your prescription medications, exact dosages, and preferred healthcare providers ready to enter into the tool. Medicare.gov will calculate your estimated total yearly costs for every available plan and show whether your preferred doctors and pharmacies are in-network. Once you find the plan that works best, you can enroll. 

If comparing plans feels overwhelming—especially when it comes to prescription coverage—don't hesitate to lean on your community pharmacist. Pharmacists do far more than dispense medication; we are accessible medication experts who understand plan formularies, tier structures, and copays inside and out. Your local pharmacist can provide an up-to-date printout of your current medication profile to plug into Medicare.gov, help verify whether your maintenance medications are covered on a plan's preferred drug tier, and explain whether a plan uses preferred pharmacy networks to lower your copays. Before you lock in your choices for the new year, stop by your pharmacy counter—your pharmacist is ready to help you make informed decisions about your medication coverage.