Annual enrollment season for Medicare starts on Oct. 15. It’s the time of year when many people will take their first steps into the world of Medicare. With careful planning and thoughtful discussion you can help to keep those first steps from being calamitous.
Whether this is your first time navigating the system or you are looking into a change in plans you should first start by considering your current medical need. Every year people pick the lowest cost option that ends up costing them more than intended.
June Sladek, Medicare insurance adviser with Advanced Insurance Solutions in Aurora, said that a needs assessment during the medicare enrollment process should look at your medical needs as well as your financial decisions.
“It is always good practice to assess your needs annually to determine whether a change is necessary or beneficial,” Sladek said.
That assessment is important because Sladek said many people come to her and want to sign up for the same plan a spouse or family member has. There is a certain comfort in that familiarity, but it also can cause issues in a few months when it isn’t really meeting a person’s medical needs.
Ron Fleeter, president of The Benefit Source, Inc., said that “it’s important that people considering enrolling in Medicare have a clear understanding of all of the medications they take and physicians they see.”
He suggested that you start to gather this information early to give you time to consider all of your plan options.
Those who are currently enrolled in a Medicare plan can find themselves having made a costly mistake by simply sticking with the status quo. Even if you are happy with the plan you are on now, it’s important to investigate what changes are in the works.
“Each year insurance companies change product offerings and make changes to plan designs, Rx formulary lists and premiums,” Sladek explained. “A big change in 2027 affects those considered dual eligible or those who have both Medicare and Medicaid. New government rules are reducing carrier options, with some carriers discontinuing Dual Eligible Special Needs or D-SNP plans and mapping members to a standard plan with lower benefits.”
Seniors aren’t the only ones with a focus on the Medicare enrollment period. Scammers have it circled on their calendars as well.
“It’s important for people to be wary of anything that comes in the mail or that is cold-calling you about Medicare,” Fleeter said. “Oftentimes, they just want your information.”
Sladek said that “many seniors fall victim to fraud by taking calls attempting to get seniors to enroll in a plan over the phone.”
“Once enrolled, many learn their physician isn’t in-network,” she said. “The worst part is that, in some cases, members must wait until the next open enrollment to change plans.”
When you’ve done your research and have your information ready, Fleeter said that the timing of enrollment is important, particularly if you are coming from an employer’s plan.
“You want to make sure you don’t have any overlap,” he said.
Noell Wolfgram Evans is a freelance journalist.