The Daly Peak

Is your Medicare plan right for you?

 As the SHIP Medicare Coordinator for the region, I am responsible for providing important services for our 65 and older population and for those who are Medicare eligible due to a disability. After our introductory year, we heard the call for more availability to individual Medicare assistance, more community education opportunities, and more chances to learn about Medicare fraud and prevention. I've been busy with outreach and education, presenting Medicare Basics workshops, and helping navigate the complexities of the program.

 Right now, our team is busy working to help people with Medicare during the Annual Open Enrollment Period (AEP). The AEP is designed to give Medicare plan participants change or enroll for the first time in a Part D prescription drug plan and Part C Advantage supplement plans.

I encourage everyone to research and compare their existing plans with the new plans available for 2018. Health insurance carriers are allowed to change premiums, discontinue covering medications, and change plan terms every year. Plans also tend to raise premiums every year if one simply lets the plan roll over every year.

We employ an easy to use comparison tool Plan Finder on Medicare.gov to evaluate the 2018 plans offered, and we compare people's existing plan to the new plans the Division of Insurance has vetted -- making sure people are in the best plan to meet their coverage needs at the best price. The two most important things to look for is that all prescription medications are still covered by the plan and that they are paying a fair price to meet their coverage needs.

I worked with a woman who has had medications added new medications every year for the last couple of years. She has had no problems with her Part D prescription drug coverage. She did not think it was necessary to compare drug plans because she was happy with what she has.

One of our Certified SHIP Medicare Assistance Counselors mentioned that it would be wise to at least look to make sure all of her medications were on the plan's formulary and check to see if her medication list was updated. They discovered that three of her medications were not on her plan's formulary and next year another one would no longer be covered. She did not realize she had not been getting the plan benefits for those medications. They also discovered that her premium had risen $30 per month since she first enrolled in her existing plan.

Once her medications were updated, they did a plan comparison between her existing plan and all of the plans offered in 2018. She is now a bit happier and will see a $3,721 annual savings because she found a new prescription drug plan that will cover all of her medications and will have a lower monthly premium than the plan she had loved before. As she left she remarked, "Now I know what I will be doing next fall and every fall after that!"

Open enrollment for Medicare ends on December 7, 2017. If you or a loved one still has questions, they can reach out to me at 970.468.0295 x120 or email me here tjdufresne@nwccog.org.