If you’re on Medicare, you have most likely been receiving all kinds of mail in the past few weeks about the upcoming AEP, or Annual Enrollment Period for 2015. Typically these publications are dense, confusing, and let’s face it, boring. You may be saying to yourself, I like my plan, why do I need to bother with AEP at all? I’m here to explain why:
– Your plan’s benefits may have changed. Perhaps you were taking a medication that was generic and only cost $2 for a 30-day supply. For 2015, generics on your current plan may go up to $10. Your favorite local pharmacy may no longer be considered a “preferred” pharmacy. Don’t assume your current benefits will carry over into next year, and this issue applies equally to Medicare Advantage and Part D Prescription plans.
– Your plan’s formulary may have changed. The formulary, or list of medications for which your plan has negotiated discount rates with the various insurance companies, can and does usually change annually. To you it could mean the difference between a preferred generic, which costs $0, and a non-preferred generic, which costs $10.
– Your plan no longer exists. As weird as it sounds, the plan you’re on now may be going away altogether. Sometimes insurance companies want to move out of a particular market, or have some other business reason to discontinue a plan. As painful as this issue can be for Part D Prescription plans, it’s even more stressful when you are using Medicare Advantage for medical coverage.
– Your medications have changed. The plan that made sense for you and your specific medical issues a year ago may be a poor fit now. One of the great things about having the ability to change plans annually is that you aren’t locked into a plan that you’ve outgrown.
– Your method of purchasing medications has changed. Many drug plans allow you to buy drugs either at a retail store or via mail order. Some plans only allow for one or the other. If you’ve made a switch from one to the other during the past year, your current plan may not be able to accommodate your new preference.
– Your doctor is no longer in the network. If you are on a Medicare Advantage plan, you may find that your doctor that you’ve been seeing since 1993 is no longer participating with your plan. Chances are, he or she has moved to another plan, so you would need to take action to make sure you have continuity of care (as well as a doctor who knows you very well!).
The good news is that if any of these situations apply to you, you don’t need to sort through all of it yourself. Here are the important dates to know for AEP:
10/1: Agents and insurance companies are allowed to start helping you review your current plan and potentially help you select a new one.
10/15: Agents and insurance companies can begin accepting applications for 2015 plans.
12/7: The AEP for 2015 ends. Whatever plan you have in place by this date will be the plan you have for all of 2015.
If you have an agent, all you need to do is gather:
– a list of your current providers – doctors, lab locations, hospitals, pharmacies
– a list of your current medications and the medicare doses
– whether or not you can take a generic version of each medication
If your agent has this information, he or she will be able to find the best plan for you in 2015. Take advantage of this valuable service and forget about being overwhelmed by AEP. Help is always available!