Medicare open enrollment starts this month. Here’s what you need to know. | St. Louis Public Radio

Medicare open enrollment starts this month. Here’s what you need to know.

Oct 6, 2015

Credit (via Flickr/ellie)

Open enrollment for Medicare starts this month, on Oct. 15, and closes Dec. 7.  It is the only time of the year that plan beneficiaries have the ability to change their Medicare health and drug plans.

Plan costs and coverage benefits seem to change almost as soon as they are enacted. Around 1700 people in the St. Louis area alone will be impacted by their Medicare Advantage plan not renewing their contract with Medicare, making open enrollment an important part of the year to pay attention to.

On Tuesday’s “St. Louis on the Air,” host Don Marsh discussed open enrollment with Julie Brookhart, a public affairs specialist with the Kansas City office of Centers for Medicare & Medicaid Services.

What kind of adjustments can be made during the open enrollment period?

“Every year, in the fall, Medicare beneficiaries have a chance to review health and prescription drug coverage and compare what will be available the next year,” Brookhart said. “Basically, the plans and costs and benefits can change every year but also, too, beneficiaries needs can change. They may have dropped some prescription drugs from the last year or may have added some on. This is the time of year to do that check-up and make sure you’re in the most cost-effective and beneficial plans for your needs.”

Where can people look for information they need regarding their plans?

Brookhart also shared several resources for those with questions:

  • Visit www.medicare.gov
  • Call 1-800-MEDICARE (633-4227). “Basically, they’re our customer service reps who can help you compare plans over the phone and give you a little bit of information,” Brookhart said. They can direct you to very local help in your area, your local State Health Insurance Assistance Program.”
  • Contact Missouri’s State Health Insurance Assistance Program directly at 1-800-390-3330.
  • Here is a list of open enrollment events across the state of Missouri to attend for more information. 

To what does “plan” refer?

“Besides your original Medicare, Medicare beneficiaries can choose to get their health benefits through Medicare Advantage plans, HMOs, PPOs, those sorts of plans,” Brookhart said. “Those are plans that contract with Medicare to offer the same kind of benefits that original Medicare does, but sometimes they offer different benefits. Sometimes a beneficiary might want to go from a Medicare Advantage to an original Medicare plan or vice-versa.”

“And then there’s the prescription drug portion,” Brookhart added. “Beneficiaries who are on original Medicare do have to sign up for a separate Medicare Part D Plan.”

For those with supplemental insurance outside of Medicare, does open enrollment apply to those plans?

“They’re not really part of the open enrollment process, but you can work with a State Health Insurance Assistance Program counselor can talk to you about options for your supplemental policies as well,” said Brookhart. “The state has regulation and oversight over Medi-gap.”

How should people react to insurance companies’ flyers arriving at their doors?

“Well, they are allowed to market to Medicare beneficiaries and they can start doing so after Oct. 1,” Brookhart said. “We just say, you want to look at all your options. We just say you should do your research and not just go with the first plan you pick up. That’s why we offer you free resources from Medicare.”

What are the red flags to watch for regarding Medicare fraud?

“One of the most common ploys during open enrollment is that someone may call your house during open enrollment posing as an employee of an insurance company or even Medicare,” Brookhart said. “They might say there are new cards being issued during this time of year for every beneficiary, so they might ask you to verify sensitive information such as your Medicare number, which is your Social Security Number.  They might try to get that information over the phone. We tell people to never give their Social Security Number over the phone because if we’re calling you, we already have that information on file and an insurance agent should not be asking you for that information.”

Wondering about first-time enrollment or what’s ahead in changes in Medicare? Listen to the rest of the interview here:

"St. Louis on the Air" discusses issues and concerns facing the St. Louis area. The show is produced by Mary EdwardsAlex Heuer and Kelly Moffitt and hosted by veteran journalist Don Marsh. Follow us on Twitter and join the conversation at @STLonAir.