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Health Reform 101

with Lisa Zamosky

WebMD helps readers understand their health insurance and the new health care reform law. The Affordable Care Act is bringing sweeping changes to American health care. Lisa Zamosky is here to help you navigate the health care maze and understand how these changes affect you.


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Thursday, December 6, 2012

Signing Up for Medicare Benefits, Act Now!

By Lisa Zamosky

Medicare Card

Back in October, I wrote about the start of the Medicare Annual Election Period (AEP).  As a reminder, this is the time during which Medicare beneficiaries can:

* Enroll in a Part D drug plan to help pay for prescription drugs
* Change an existing Part D plan to a new one
* Return to traditional Medicare from a Medicare Advantage plan
* Enroll in a Medicare Advantage plan for the first time
* Change from one Medicare Advantage plan to another

    AEP ends tomorrow, December 7th, so if you haven’t yet taken action, now is the time.

    The Medicare Rights Center, which is a not-for-profit organization and an excellent source of Medicare information and advice, offers a list of questions to consider when evaluating both Medicare Advantage and Part D prescription drug plans.

    If you’re planning to take last minute action to alter your Medicare benefits before AEP ends tomorrow, use these questions as guide to choosing the best possible plans to meet your needs.

    Medicare Advantage

    Before signing on to a Medicare Advantage plan, ask yourself the following:

    • Will I be able to use my doctors? Are they in the plan’s network and are they taking new patients who have this plan?
    • Have my doctors’ experiences with this plan been positive? What problems have my doctors seen with patients in this plan?
    • How much will it cost to see my primary care physician? A specialist?
    • Do I need a referral to see a specialist?
    • What service area does the plan cover?
    • What kind of coverage do I have if I travel outside of the service area?

    For a more complete list of questions, you can check out the organization’s Medicare Interactive website.

    Part D Drug Plans

    The Medicare Rights Center suggests looking into the following before committing to a Part D drug plan:

    • Are the drugs I take covered by this plan?
    • Are there coverage restrictions, such as quantity limits, prior authorization, and step therapy?
    • Can I fill my prescriptions at the pharmacies I use regularly?
    • How much will I pay at the pharmacy (copayments or coinsurance) for each drug I need?
    • If a drug I take has a very high coinsurance, is there a drug I can take that will cost me less? (Ask your doctor.)

    Again, for a more complete guide about how to compare and select the best drug plan, take a look at the Medicare Rights Center website.

    Getting Expert Help

    To get personal assistance choosing Medicare Advantage or Part D coverage, here are a few resources to contact:

    For more Medicare resources, check out my previous post on the topic here.

    Have you waited until the last minute to sign up for Medicare? What’s kept you from acting? Share your thoughts in the comments section below.

    Photo: Ingram Publishing

    Posted by: Lisa Zamosky at 1:00 am


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