Medicare Annual Enrollment: Know what you need to do


Advice | Toni Says

Editor’s note: It is five weeks until Medicare’s annual enrollment, Tuesday, Oct. 15.

Dear Toni: This is my first Medicare Annual Enrollment, and I don’t know anything about this process. Which program is good, and which one is not? I do have some health problems and am concerned I am making the correct choice. Which Medicare health plan should I change to and should I change my Medicare Prescription drug plan? I will really appreciate your help. — Thanks Fred from Tulsa, Oklahoma

Dear Fred: To find which Medicare option is best depends on which option is best for your health and financial situation. You may be someone who only goes to the doctor once a year or you might be someone who has a long history of health issues. Take your time and research your options.

Below are three steps the Toni Says team uses when helping clients during Medicare Annual Enrollment.

Step one: Decide if you want Original Medicare (Parts A and B) or Medicare Advantage (Part C) plan.

Talk to your doctor’s office and see which plan is recommended. Some doctors are accepting Original Medicare and not Medicare Advantage plans. If you have a doctor who is in the Medicare Advantage plan’s provider directory, make sure you call to verify the office is still accepting that plan or ask the doctor’s office if they are accepting the MAPD plans you are interested in.

The main difference between Original Medicare and Medicare Advantage plans is Original Medicare works only with Medicare, and generally, you or your Medicare supplemental plan pays the deductibles or coinsurances.

A Medicare Advantage plan is also called Part C and is administered by private insurance companies that are approved by Medicare. You must use that insurance company’s card not your Medicare card.

Step two: Decide if you want Medicare Part D prescription drug coverage or need to change your current Medicare Part D plan during the annual enrollment period.

If you want Medicare Prescription Drug coverage to go along with Original Medicare, then you must enroll in a standalone Medicare Part D plan. There is a monthly premium.

If you choose a Medicare Advantage plan, make sure that the plan has Part D Medicare Prescription Drug coverage included to keep from receiving a penalty for not enrolling in a prescription drug plan.

Step three: Remember you have from Oct. 15 to Dec. 7 to change your Medicare Advantage or Medicare Part D plan to begin Jan. 1, 2020.

When changing to a Medicare Advantage plan, verify that your doctors are in that specific provider network.

Verify that your and/or your spouse’s prescriptions are in the specific MAPD formulary.

For a Medicare Enrollment Checkup call the Toni Says Medicare Hotline at 832-519-8664 regarding your Medicare plans and options.