Medicare’s open enrollment period, which started last week, can be a confusing and cumbersome process for many consumers. But there are tools and resources available to cut through the jargon and help seniors find the best health plan.
The enrollment period runs through Dec. 7 and provides people 65 or older with a once-a-year opportunity to switch to a private Medicare Advantage plan or change their prescription drug coverage. It also lets people switch to traditional Medicare.
The Missouri Department of Insurance has partnered with Primaris, a Columbia-based health care consulting firm, to offer assistance to seniors sifting through their options.
Those who want to review their current plan, change their drug coverage or enroll can get advice from the Community Leaders Assisting the Insured of Missouri program.
“Even if you are happy with the one you have now, it may be changing,” said Revee White, the marketing director for Primaris. “You need to make sure it is still the best choice for you.”
The program has about 300 counselors who can help seniors with their options. They can also assist low-income residents in determining whether they qualify for federal or state assistance in paying for prescription drugs.
Call 1-800-390-3330 or visit missouriclaim.org for assistance.
Also available is a federal rating system of Medicare Advantage and prescription drug plans currently on the market. Plans are rated on a five-star scale with five stars being the highest.
When rating plans on medicare.gov, federal officials take into account customer satisfaction and how individual plans keep consumers healthy and help them manage chronic conditions.
Jim Day, a regional liaison for Primaris, said the ratings can be a good indicator of what kind of service an insurer offers, but isn’t the best way to determine whether an individual should purchase a plan.
“Just because the plan is rated very highly, does not mean it is a good fit for the beneficiary,” he said.
Day added that residents should check with their local hospitals, doctors and pharmacies to make sure they are in a plan’s network before enrolling.
About 16 million people, or 30 percent of Medicare beneficiaries, are enrolled in Advantage plans. An additional 23 million people are enrolled in prescription drug plans.
For this year’s enrollment period, there won’t be as many choices of Advantage and standalone prescription drug plans, and premiums are expected to rise modestly.
There will be 46 Medicare Advantage plans available in Missouri, down from 54 last year. Nationally, the average premium will increase by about $3, but federal officials say two-thirds of beneficiaries won’t see any hike.
Similarly, there will be 31 standalone prescription drug plans, down from 35 in 2014. Premiums are expected to rise by about 2.4 percent on average in Missouri, although many consumers could face double-digit increases.
Day said there were still plenty of available prescription drug coverage options for 2015 but cautioned that was not necessarily the case for Medicare Advantage. “For the Advantage plans it really depends on where you are and the networks that are available,” he said.
This report was prepared in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.