Medicare open enrollment 2020: Skipping this step, or rushing through, could cost you

About 60 million Medicare recipients have the chance to change their coverage during the health care service’s annual open enrollment season, which opened on October 15 and closes on December 7. But research indicates fewer than 4 in 10 seniors review their Medicare plan each year to find the best deal.

That means millions of Medicare recipients may be making a costly mistake: The program’s open enrollment period represents the only time of the year when seniors can tweak their drug coverage, says Diane Omdahl, the chief executive and founder of 65 Inc., which provides fee-based Medicare advice to seniors. Skipping the process, or rushing through it, can mean losing out on savings or choosing a plan that doesn’t cover your prescriptions, she adds.

Medicare’s complexity may explain why seniors are more likely to check for cheaper auto insurance or cable plans than reassess their coverage each year, according to research from WellCare Health Plans.

“If I put a nickel away for every time I hear, ‘How do normal people do this?’” Omdahl says. “When you think back to when Medicare started in 1965, those who hit 65 had already hit their life expectancy. They retired at 65. Medicare was one-size-fits-all.”

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That’s not the case now. Medicare Advantage plans, offered by private insurance companies, provide coverage of Part A and Part B, or hospitalization and doctor visits, respectively. Some also include drug coverage. While they are gaining in popularity, with one-third of Medicare recipients now enrolled in one, they also add to the complexity of choosing the best plan to fit your needs.

“The more complex it becomes, the more the risk for errors,” Omdahl adds.

Medicare Plan Finder update

And this year may prove even more complex. An updated Medicare Plan Finder, the online comparison tool run by the Centers for Medicare & Medicaid Services, means seniors should plan on taking extra time to familiarize themselves with the new technology, Omdahl recommends.

Some Medicare Advantage plans are also offering expanded non-medical benefits in 2020, such as covering rides to doctors’ appointments or grab bars – extras that may seem enticing but should be scrutinized carefully, says Casey Schwarz, senior counsel for education & federal policy at the Medicare Rights Center, a nonprofit consumer service group.

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Below are four tips about how to approach open enrollment:

Know what you can and can’t do

Medicare’s open enrollment period isn’t about enrolling in the program; that’s pegged to when you turn 65.

Instead, the open enrollment period allows you to make a number of changes if you’re already enrolled. According to the Medicare.gov, the major changes you can make include:

• Switch from Original Medicare to a Medicare Advantage plan or vice versa.
• Change your Medicare Advantage plan
• Join a Medicare prescription drug plan or pick a new drug plan                                
• Drop your drug coverage

But the current open enrollment period isn’t the only chance to make changes to Medicare Advantage plans. There’s a do-over window that runs from January 1 through March 31 that allows you to pick a new Medicare Advantage plan if you already have one.

However, switching from Original Medicare to a Medicare Advantage plan isn’t possible during the January-March window, nor is switching drug plans if you’re in Original Medicare, according to Medicare.gov.

Don’t skip the process

The biggest pitfall facing seniors is simply skipping the open enrollment period, says Medicare Rights Center’s Schwarz.

“Ignoring it or not engaging in the process, assuming that because things are fine, your drugs will still be covered” in 2020 can lead to unwelcome surprises, she says.

Medicare Advantage and Medicare Part D, which are drug prescription plans, can change their formularies – which drugs they cover – from year to year, or even mid-year, experts say. That’s why you should check your plan’s 2020 coverage and assess whether another plan might offer a better deal.

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Don’t rush

Take your time during the current open enrollment period to analyze the options and think through your health needs for 2020, experts say. As mentioned above, the Medicare Plan Finder has been updated, which means seniors may need extra time to become acquainted with the new service.

The revamped finder allows you to compare three plans side-by-side. But Schwarz says it doesn’t sort plans by which medications are on their formularies. That means you’ll need to drill down into each plan to check drug coverage.

Medicare enrollees can also get free help through their State Health Insurance Assistance Programs, or SHIP. Services such as Omdahl’s 65 Inc. will also provide guidance for a fee, while some insurance brokers that sell Medicare Advantage plans also offer guidance on picking plans.

Read the fine print and call providers

Be prepared for extra research if you’re considering a Medicare Advantage plan. Unlike Original Medicare, Medicare Advantage plans provide coverage for networks of doctors and providers, which is why experts recommend calling your medical specialists to check whether they’ll be included in your 2020 plan.

Likewise, the expanded non-medical benefits in Medicare Advantage plans next year may seem appealing, such as getting access to transportation to medical appointments, Schwarz says. But read the fine print. 

“Understand what these benefits are and who is eligible for it,” she recommends. “The non-medical benefits may only be available to people with certain chronic conditions.”