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home : opinions : commentary April 29, 2016


10/26/2013 12:27:00 PM
Commentary: Time to review your Medicare coverage
By: David Sayen


Medicare's annual open enrollment period has begun, and I want to encourage everyone with Medicare to review their current health and prescription drug coverage.

Open enrollment runs through Dec. 7. If you want to change your Medicare Advantage or Medicare Part D (prescription drug) plan, this is the time of year to do it. Any new coverage you select will kick in on Jan. 1, 2014.

If you have Original Medicare and you're satisfied with it, you don't need to do anything during open enrollment. Also, Medicare's open enrollment has nothing to do with the Affordable Care Act's new Health Insurance Marketplace. If you have Medicare, you don't need to worry about Marketplace plans.

My agency, the Centers for Medicare & Medicaid Services, or CMS, announced recently that the average Medicare Advantage premium for 2014 is projected to be $32.60. CMS estimated that the average basic Part D drug premium in 2014 would be $31 per month, holding steady for four years in a row.

Since the Affordable Care Act was passed, average Medicare Advantage premiums are down by 9.8 percent. The deductible for standard Part D drug plans in 2014 will be $310, a $15 decline.

Meanwhile, the quality of Medicare Advantage and Part D drug plans continues to improve, with more than one-third of Medicare Advantage plans receiving four or more stars (out of a possible five stars) in 2014 -- a 28 percent increase over last year. Medicare Advantage and Part D drug plans with five stars are allowed to enroll beneficiaries at any time during the year.

Medicare plans' coverage options and costs can change each year, and Medicare beneficiaries should evaluate their current coverage and choices and select the plan that best meets their needs. If you think your current coverage will meet your needs for 2014, you don't need to change anything.

For more information on Medicare open enrollment and to compare benefits and prices of 2014 Medicare Advantage and Part D drug plans, please visit: www.cms.gov/Center/Special-Topic/Open-Enrollment-Center.html.  

A variety of resources are available to help people with Medicare, their families, and caregivers compare current coverage with new plan offerings for 2014. You can:

·      Visit www.medicare.gov to see plan coverage and costs available in your area, and enroll in a new plan if you decide to make a change. Open enrollment information is available in Spanish.

· Call 1-800-MEDICARE (1-800-633-4227) for around-the-clock assistance to find out more about your coverage options. TTY users should call 1-877-486-2048. Counseling is available in a wide variety of languages.

· Review the 2014 Medicare & You handbook. This handbook has been mailed to the homes of people with Medicare and it's also online at: www.medicare.gov/pubs/pdf/10050.pdf.

· Get one-on-one counseling assistance from your local State Health Insurance Assistance Program (SHIP). Local SHIP contact information can be found:

o At www.medicare.gov/contacts/organization-search-criteria.aspx or;

o  On the back of the 2014 Medicare & You handbook or;

o  By calling Medicare (contact information above).

People with Medicare who have limited income and resources may qualify for Extra Help paying for their Part D drug plans. There's no cost or obligation to apply for Extra Help, also called the low-income subsidy. Medicare beneficiaries, family members, or caregivers can apply online at www.socialsecurity.gov/prescriptionhelp or call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778) to find out more.

Please watch out for scammers during Medicare open enrollment season. Don't give personal information to anyone who shows up at your home uninvited or makes an unsolicited phone call to sell you Medicare-related products or services. If you believe you're a victim of fraud or identity theft, please contact 1-800-MEDICARE. More information is available at www.stopmedicarefraud.gov.



David Sayen is Medicare's regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).


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Reader Comments

Posted: Monday, October 28, 2013
Article comment by: Frank Lee Confused

Those who depend and like Medicare are generally older, common sense, middle class folks. Surely they can understand why everyone would want health insurance.

Posted: Sunday, October 27, 2013
Article comment by: Hello David Sayen, ...

Is there a connection between Medicare and
ACA (aka ObamaCare)?

Its been reported that funding will be detoured
away from Medicare and given to ACA/Obama-
Care. When will this happen?




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