Tools and tips for navigating Medicare open enrollment
Known as open enrollment, the annual process starts Sunday, Nov. 15, and goes through Dec. 31. As in years past, health-policy experts advise older Americans to not assume that their current plan, which may have worked well this year, will be as effective (or even exist) next year. Further, an existing plan could cost more -- much more -- come January.
Choosing a plan can be daunting. That's because unlike open-enrollment for workers in employer-sponsored plans, which may involve just a handful of choices, seniors literally have dozens of plans from which to choose. "That's why people need to shop -- painful as it is," says Bill Vaughan, health policy analyst at Consumers Union, publisher of Consumer Reports. "It's something people should do each fall."
New data show that shopping during open enrollment saves as much as $2,019 on a package of five common drugs, according to comparisons conducted by CU. Potential savings vary by locale and medication history, so seniors should check new prices.
"Some plans that were good in the past have become pricey bad deals," Vaughan says. "Plans that were so-so before are now big savers." CU notes, for example, in New York state, among 43 plans with comparable data between 2009 and 2010, 28 will go down in total cost, which includes premiums, deductibles and co-pays, and 15 will go up, according to data available at Medicare.gov.
The best tool seniors have their at their disposal is the Medicare website, Vaughan says. Seniors who aren't comfortable navigating the Internet may want to enlist the aid of an Internet-savvy youngster. (Seniors can also call 800-Medicare or 800-633-4227.)
Another resource seniors can turn to turn are State Health Insurance Counseling and Assistance Programs, or SHIPS, says Lee Thompson, executive director at Health Assistance Partnership. Consumers can either call the agency in their state for free advice about choosing a plan or set up an in-person meeting, she says.
One scenario seniors should avoid are insurance company-sponsored meetings, typically held at local diners, which offer information about one company's products and offer to enroll attendees in one of those plans. "We call that a sales presentation," Thompson says. More often than not, such gatherings tend to be biased toward the sponsoring insurer's products.
Such meetings shouldn't be confused with seminars sponsored by SHIPS where all insurers are invited to attend and share information. "Those are educational presentations," Thompson says. "Nobody gets enrolled at them, but you would get a cross-section of plan information directly from the plans."
Making the Choices More Obvious
One step the Obama administration has taken to help seniors in making choices is to require insurers to reduce the number of plans that look similar, says Marc Steinberg, deputy director of healthy policy at Families USA, a health-care advocacy organization. For example, if a company offered four or five plans that were hard to tell apart, it has to merge them to create more distinguishable choices, he explains.
"Clearly, over the last several years there have been too many plans in the market," Steinberg says. Choice is a wonderful thing, but when presented with so many offerings, seniors tend to select names most recognizable to them, he adds. "And that's not necessarily in their financial interest."
When it comes to shopping for Medicare plans, CU's Vaughan concedes, it can be downright tedious. "It isn't exactly fun shopping," he says. "It's not like going out and buying new clothes or something for the grand kids." Indeed, it's not -- it can be a matter of ensuring your well being.
Seniors are advised to protect themselves against high-pressure and misleading sales tactics as annual enrollment gets underway. Here are a few guidelines to keep in mind, provided by the New York State Insurance Department:
- Unsolicited contacts are improper: Federal regulations prohibit insurance agents from contacting customers without express invitation. This includes door-to-door sales, unsolicited emails and phone calls.
- Ask a relative or friend to be with you: Selecting an insurance policy can be a complicated process for anyone. It's a good idea to have a relative or trusted friend with you whenever you meet with an insurance agent.
- Medicare has no sales agents: Medicare does not send "representatives" to solicit business. Be especially wary of any salesperson who claims to represent the program.
- There's no free lunch: Federal regulations prohibit the offer of a free meal in exchange for listening to a Medicare Advantage sales presentation.
- Read and understand the policy: Seniors considering changing their Medicare Advantage or Medicare Prescription Drug plans should be aware that not all policies are the same. They should carefully consider their needs and how a particular policy would meet those needs, making sure their providers accept the plan prior to enrolling.