The Medicare Maze

October 28, 2011 in Medicare, Member Stories

If you’re 65 or older, or if you have a loved one who is, it’s now Medicare Open Enrollment. This year, the period has shifted earlier in the year, and will end on Dec 7 instead of Dec 31.

So, who does this affect? Anyone who is signing up for Medicare for the first time, or people who want to change their Medicare Part D (prescription drug) plans or Medicare Advantage (the privately run program that wraps up Medicare Parts A (hospital visits), B (doctor visits) and D (prescription drugs) into one plan).

On the Here & Now show, we spoke with a contributing editor from Kiplinger’s who told us that most people don’t end up switching plans, because they like what they have and they don’t bother to check whether things have changed. And boy, can they change.

The biggest issue tends to be for prescription drugs. During the course of the year, plans sometimes drop drugs, or increase the co-pays. So someone could go from paying $20/month for a drug to $40/month! Or lose drug coverage altogether.

The best thing to do is to review your plan. If you want more info, listen to our interview on Here & Now.

My mom’s coming to visit next week, and we have already scheduled time to sit down and review her plans!

3 responses to The Medicare Maze

  1. Kevin,
    Actually the open enrollment period does not effect anyone “signing up for Medicare for the first time…” Such people have a seven month window to sign up, not just seven weeks.

    Also — although it doesn’t matter to seniors — all Medicare programs are privately “run.” The major difference is that seniors cannot choose the private insurer that administers A and B in his or her state while he or she can choose an insurer for C, D or Medigap.

    There were three inaccurate statements in the NPR story about the “Here & Now show.” Perhaps the show itself was accurate. See the comment I left on the NPR site (as well as on CommonHealth).

    Seniors should see if they qualify for a State Pharmaceutial Assistance Program (called Prescription Advantage in Massachusetts). In Massachusetts at least, the program lets the senior switch Part D or C plans once during a year (in addition to open enrollment time) if a drug co-pay goes from $20 to $40 or a drug is dropped from a formulary. Not everyone qualifies but it’s worth looking at.

    But the following statement is very accurate: “…most people don’t end up switching plans, because they like what they have and they don’t bother to check whether things have changed. And boy, can they change.” That is especially true this year because most plans on the average are staying the same or even going down. People read the letter from their current insurer and think “Hey, that’s great” without checking to see if another plan could save them even more.


  2. Dear Dennis,
    If you worked on your mother’s Part D plan in early November on the website, check it again. I found that many of the costs listed there changed between Nov 12th and Nov 19th! What promised to be a $400 savings on the 12th turned out to be no savings at all by the 19th and I had to switch my Mom back to her original plan. No wonder people don’t like to switch!

  3. @ Virginia

    Actually I think it is Kevin that worked on his mother’s Part D plan. But I am very surprised that any prices changed that late in the process. What state/county are you in? I know a lot of people who would want to know about this? Thanks

Leave a reply

You must be logged in to post a comment.