You may make changes to your Medicare Part D prescription drug plan coverage each year during Medicare’s Open Enrollment Period, which runs Oct. 15 to Dec. 7. Beginning in September, you may receive notices with information about possible changes to your coverage for the coming year. Please read these notices, as these can help you decide if you should make changes to your coverage during Medicare’s Open Enrollment Period.
If you are currently enrolled in Medicare, watch for the “Medicare & You” handbook in the mail in September and review your health care benefits. If you do not receive one, you can call 1-800-MEDICARE (1-800-633-4227) and request that a copy tailored for Alaska be mailed to you. You may also download the general handbook at www.medicare.gov. You could contact one of the certified Medicare counselors at the State of Alaska’s Medicare Information Office by calling either 800-478-6065 or 907-269-3680 for answers to any questions about Medicare benefits.
To learn about your employer-provided retiree benefits and/or Medicare Supplement Insurance (Medigap) plan coverage, please call your plan directly or read your plan’s handbook. The State of Alaska’s Division of Insurance has also recently updated the Medigap Consumer Guide. Copies are available online, or you may call the Medicare Information Office and we will be happy to mail a printed version.
Notices coming your way
If you have a Part D prescription drug plan, you should receive a notice called an Annual Notice of Change (or ANOC for short) and an Evidence of
Coverage (or EOC). Your plan should send you these notices by Sept. 30. If you do not receive these notices, contact your plan to request copies. These notices list any changes for your plan in the upcoming year 2023.
There are three kinds of changes to look for in an ANOC or EOC. First, look for changes to your plan’s costs for the upcoming year. Costs such as deductibles and copayments can change each year. Second, look for changes to the plan’s network; make sure to see if your preferred pharmacies will still be in network in 2023. And third, look for changes to the plan’s formulary, which is the list of drugs the plan covers. Formulary changes can happen from year to year, meaning your drug may not be covered next year even if it is currently included in the plan. Even if it is still on the plan’s formulary, the cost (or tiered pricing) of your drug may have changed. After reading about the changes to your coverage for 2023, decide whether your plan will still be able to meet your needs in the upcoming year.
If your plan is no longer available
In October, plans leaving the Medicare program in the coming year send out a Plan Non-Renewal Notice to plan members. If you receive this notice, you should take action to make sure you are covered in 2023. You can choose to enroll in a new Part D prescription drug plan during Medicare’s Open Enrollment, which, again, is Oct. 15 through Dec. 7. You can also enroll in a new plan up until the last day in February of the following year. You will be disenrolled from your previous plan starting Jan. 1, though, so if you do not pick a new plan by then you will likely experience a gap in coverage until you enroll in a new plan.
Poor quality plan? Replace it
In late October, Medicare also sends a Consistent Poor Performance Notice to people enrolled in a plan that has received a low rating on quality and performance for three or more years in a row. A low rating is three stars or fewer out of five. The notice encourages you to look at other plan options in your area. These star ratings are also online at http://www.medicare.gov when comparing prescription drug plans, using the website’s Plan Finder tool.
As Medicare’s Open Enrollment Period begins, you will likely start receiving mail from different insurance companies about the plans they offer. You can use this marketing information to compare your options. You should know, though, that companies must follow certain rules when marketing their plans. These guidelines are in place to protect you from manipulative sales and enrollment tactics.
For example, a plan cannot use language that suggests their plan is preferred by Medicare. They also cannot call or email you if you did not ask them to do so or if you have no prior relationship with them. Plans should additionally not leave information like flyers or door hangers on your car or at your home if they came from a company that did not have an appointment with you. When contacting plans, remember that you should take your time to review your choices and make an informed decision.
For any Medicare related questions, please feel free to contact the State of Alaska Medicare Information Office at 800-478-6065 or 907-269-3680. Our office is also known as the State Health Insurance Assistance Program (SHIP), the Senior Medicare Patrol (SMP), and the Medicare Improvements for Patients and Providers (MIPPA) program.
Sean McPhilamy is a volunteer and Certified Medicare Counselor at the Alaska Medicare Information Office.
