What to Do During Medicare Open Enrollment

Social Security card and Medicare enrollment form; Shutterstock ID 115761634; PO: DF-112612-gallery bill; billing; card; claim;
By Kimberly Lankford

Q. Do I need to do anything during the Medicare open-enrollment period this year? I've been happy with my Part D prescription-drug plan.

A. You will automatically keep your Part D coverage if you don't make any changes to it during open enrollment, which runs from Oct. 15 to Dec. 7 for 2014 plans. But it's a good idea to shop around again for Medicare Part D prescription-drug plans and all-in-one Medicare Advantage plans, especially if your health or medications have changed. Even if your premiums haven't risen much, your out-of-pocket costs could change significantly.

Many Part D plans have increased premiums, boosted copayments and changed the pricing tiers for prescription drugs. A number of plans have four or five tiers of drug pricing, and your out-of-pocket costs could go up if the insurer moves your drugs from one pricing tier to another. If a medication moves from a preferred to a non-preferred brand-name drug or specialty drug, for example, you may have to pay as much as 25 percent of the cost yourself. Some plans even have two pricing tiers for generic drugs, charging a higher copayment for non-preferred generics.

One of the biggest changes in recent years is the growth of preferred pharmacy plans. More insurers are introducing low-premium versions of plans that also charge lower copayments if you buy your drugs through certain preferred or mail-order pharmacies. %VIRTUAL-article-sponsoredlinks%The Humana Walmart Preferred Rx plan, for example, charges a monthly premium of $12.60 and copayments of just $1 for preferred generics at Walmart (WMT) and Sam's Club pharmacies, and $0 for generic drugs through the RightSource mail order pharmacy, but a $10 copayment if you buy from non-preferred network retail pharmacies. Tier 3 preferred brand-name drugs have a 20 percent coinsurance at Walmart and Sam's Club pharmacies and at the RightSource mail-order pharmacy, but a 25 percent coinsurance through non-preferred network pharmacies. (Copayments are a fixed-dollar amount that you pay for each prescription, coinsurance is a percentage of the cost that you must pay.)

To shop for a Part D prescription-drug policy or just check out your options, go to Medicare.gov's Plan Finder and type in your zip code (or your Medicare number for a personalized search), drugs, dosages and up to two pharmacies near your home. The tool lets you know if there is a generic alternative.

Click on "prescription drug plans" for Part D plans and you'll see information for all of the plans available in your area. Look at the monthly premiums, deductibles and copayments, but focus primarily on the "estimated annual drug costs" column, which includes the premiums, deductibles and copays for your specific drugs and dosages. Also look at the plans' star ratings, which assess the Part D plans' customer service, complaints and member satisfaction.

You can compare up to three plans and see where to find more information about each plan's cost and coverage. You'll also see a list of the plan's network pharmacies in your zip code and how much you can save by using a mail-order pharmacy.

For more information about shopping for a plan for 2014, see Time for Medicare Open Enrollment. You can also get assistance shopping for a Part D plan through your local State Health Insurance Assistance Program; call 800-633-4227 or go to www.shiptalk.org for contact information. You may also want to review the plan's information on the insurer's Web site before signing up for the new plan. The Medicare.gov Plan Finder information was delayed because of the government shutdown and most of the information on the site was updated by Oct. 15, but it's a good idea to double check the information with the insurer's Web site, at least when shopping in mid-October.

Note that Medicare open enrollment is not related to open enrollment for the state health insurance marketplaces. Those exchanges are only for people who are under age 65 and not enrolled in Medicare. See Changes in Medicare for 2014 for details.

More from Kiplinger:

Best States for Retirement Aren't the Ones You Might Think
See Gallery
What to Do During Medicare Open Enrollment
Not only does it have a Florida-like climate, but Tennessee also boasts the second lowest cost of living in the country. Combined with a low tax burden and great access to medical care, Tennessee is ideal for retirees living on fixed incomes, Kahn said. The only downside: the state has one of the country's highest crime rates.

One of the state's oldest towns, Sevierville, Tenn. (pictured above), provides close access to a national park where retirees can picnic, hike and fish, and it's an easy drive to Knoxville.
Another balmy locale, the state has an average temperature of 66.7 degrees -- behind only Hawaii and Florida for warmest average climate. Louisiana residents also enjoy low taxes, above-average access to medical care and a relatively cheap cost of living. Like Tennessee, though, it suffers from a crime rate that is among the nation's highest.

It may not be a retirement hot spot, but Bankrate says it should be. The state has the country's lowest crime rate, and an estimated state and local tax burden of just 7.6% -- lower than every state but Alaska. The downside: with an average temperature of 46 degrees over the past 30 years, it's pretty darn cold there.

For small town lovers, Aberdeen, S.D., holds a renowned film festival and has a historic downtown that plays host to farmers markets, haunted walking tours and holiday parades.

Photo: Conspiracy of Happiness, Flickr.com

The Bluegrass State is one of many Appalachian states to dominate Bankrate's top 10. While it may not have Florida's sunny beaches, it does boast an extremely low cost of living, warmer-than-average temperatures and a below-average crime rate.

In Louisville, retirees can stay active by walking or biking on the Louisville Loop, a pedestrian path set to eventually cover more than 100 miles. The smaller town of Danville, Ky., meanwhile, is ideal for horse lovers.

Beyond its warm weather, Mississippi also provides cheap living costs and a lower tax burden. But retirees may want to choose where they live carefully: the state has a high crime rate and subpar access to medical care. It has only 178 doctors per every 100,000 residents -- almost 100 less than the national average.

Photo: Natalie Maynor, Flickr.com

This coastal state came in above average for most factors that Bankrate analyzed, including climate, access to healthcare and cost of living. Its crime rate is one of the lowest in the country, with only 2,446 property and violent crimes per 100,000 people.

An affordable college town, Lynchburg, Va. offers the beauty of the foothills of the Blue Ridge Mountains, as well as historic Civil War sites.

Another Appalachian state, West Virginia is boosted onto the list by low crime, a cheaper cost of living and above-average access to medical care. Still, it has a colder climate than some of the other states.
Warm temperatures, low state and local taxes and a relatively low cost of living all pushed Alabama into the top 10. Yet it suffers from below-average access to medical care and a relatively high crime rate, with 4,026 crimes per 100,000 people -- almost double that of Virginia.

Home to a campus of the University of Alabama, Huntsville, Ala. offers botanical gardens and nature preserves and 19th century architecture. Near the Georgia border, Fort Payne, Ala. is a quintessential small town with activities that include an annual fiddling convention and a stop at the "world's largest yard sale."

Beyond its cornfields, Nebraska offers excellent access to hospital care, a below-average crime rate and living costs among the country's cheapest. But with a lower than average temperature, it's another state for retirees who don't mind the cold.
Like neighboring South Dakota, this state is not for retirees looking for warm weather. But it does have the second lowest crime rate in the nation, a mild estimated tax burden of 8.9% and 5 hospital beds available for every 1,000 residents.
Read Full Story