The time to apply for a new Medicare plan is here, whether it’s your first time or you want to make a switch. Also known as Medicare Open Enrollment, Oct. 15 through December 7 is an important time for your health.

Medicare coverage is very individual - one plan does not fit all. That’s why Multnomah County and our Senior Health Insurance Benefits Assistance (SHIBA) team can meet with you one-on-one to pick the best plan. If you want to book an appointment call 503 988-3646 to schedule an appointment for 1:1 counseling.

Even though picking a plan that fits your needs is an individualized experience, there are several tips to make the most of Medicare Open Enrollment.

1. Know which plan you currently have, and how it works

All Medicare Advantage and Prescription plans must mail you an “Annual Notice of Changes” to describe how your plan will change in 2018.  Make sure to read it carefully.  Will your costs be different next year?  Are your doctors, prescriptions, and services still covered in a way you can live with?  If not, you may want to do some shopping

2. Gather the information you’ll need

This includes your red-white-and-blue Medicare card, a list of the prescriptions you take, a list of the healthcare providers you use, and an idea of what services you may need in 2018 (such as surgery, dialysis, specialist visits, or other care). You’ll use this information to find a plan whose specifics match your needs

3.  Think about your priorities 

Do you have expensive prescriptions? Coverage for them might be your first priority.

Do you have doctors, hospitals or other providers that you want to keep seeing? That might come first. Perhaps coverage for specific procedures or services is the most important to you.  Any of these priorities can be used to sort the 35 available health plans down to a manageable number to look at more closely.

4. Save money by staying “in-network”

All Medicare Advantage plans have a network of providers that have agreed to provide services to you according to that plan’s rules. Make sure your providers are “in-network” with your plan – you’ll pay a lower co-pay.  This goes for lab, x-ray, therapy, and medical equipment providers, too – make sure they are in your plan’s network.  If you have Original Medicare, ask if the doctor “accepts assignment” – this means the doctors will not charge more than the Medicare-approved amount for the visit.  

5.  Save money on drugs

Check the Drug Formulary (or call the plan) to make sure your drugs are covered, and what your co-pay will be. If one of your drugs is not covered, ask which drugs in the same class ARE covered.  Take this information to your doctor to see if you can safely switch to the covered drug. Using (or switching to) your plan’s preferred generic and brand name drugs, whenever possible, can result in lower co-pays. USE the plan’s preferred pharmacies. You might save even more by using the plan’s mail-order pharmacy for drugs you take routinely.

6.  Avoid scams.  

Don’t give out your Medicare number or your bank account or credit card information to anyone over the phone, unless YOU have called THEM to request a service or purchase a legitimate item.  Be suspicious.  If it sounds too good to be true, it probably is!

7.  Got questions?  Get help!  

Remember in Multnomah County, you can contact a Senior Health Insurance Benefits Assistance (SHIBA) team member at (503) 988-3646. We’re trained and offer free, unbiased assistance with Medicare issues.

You can also attend a local Open Enrollment event in Multnomah County:

Hollywood Library

  • 10-29-18
  • 11-07-18
  • 11-21-18
  • 11-30-18

Midland Library

  • 10-26-18
  • 11-02-18
  • 11-12-18
  • 12-03-18

Hillsdale Library

  • 10-27-18

SE Asian Health and Service Center

  • 12-05-18