Tips for Consumers
1. Start early - Yes, open enrollment runs until Dec. 7. But the best time to start thinking about whether you want to change your drug or health coverage is now. If your circumstances have changed—for example, you’re taking different medications, or you’ve heard that your plan is changing—it’s important to have time to review all your options. And if you need personalized assistance, it’s easier to schedule an appointment now than if you wait until after Thanksgiving.
2. Pay attention to your mail - This is the time of year that you’ll start to get a lot of information.
Your Part D or Medicare Advantage plan sends out an Annual Notice of Coverage in September, which explains any changes happening to your plan and/or to your benefits in 2013.
If you get help paying for your Medicare, such as through the Medicare Part D Low Income Subsidy (Extra Help) or Medicare Savings Programs, you may receive mail from Social Security or Medicare asking you to verify your income or informing you of changes to your subsidy. You may also get a letter if your plan is ending service in your area, or has not met quality standards for three years. Save all of these letters, and have them on hand as you discuss your options with an SGIA (Strategic Growth Insurance Associates) counselor.
3. Review, review, review - Many people are happy with their current coverage, and would rather not check what other options are available to them. But this is a very important step, and can save you money. What should you look for? We like to remind people of the 4 Cs:
- Cost - How much have you spent in premiums, deductibles, and co-payments in 2012? How will these amounts change in 2013??
- Coverage - Does your plan cover all of the medications you believe you will need in 2013?? Do you want to get your health care and drug coverage through one single plan? If so, you should review your Medicare Advantage options.
- Convenience - To what extent will your plan restrict access to certain medications you need in 2013, such as through prior authorization or quantity limits? Can you use the plan at the pharmacy of your choice? Can you get your prescriptions through the mail if you prefer to?
- Customer service - Is your plan responsive when you have a question?