I’m sure you’ve come across those annoyingly proactive people who have all their holiday shopping done by the Fourth of July. I am definitely not one of those people, but there are certain events where it’s necessary to be prepared well in advance. The annual Medicare Open Enrollment Period that runs from October 15 through December 7 is one of these instances. When it comes to researching and comparing all available Medicare plan options, sooner is always better than later.
Family caregivers already have an awful lot on their plates. When we’re overwhelmed, the natural human response is to deal with the “have-to” tasks first and put off the “need-to” tasks until they become more urgent. However, procrastinating on Open Enrollment could have medical and financial implications that last throughout 2023.
Now is the perfect time to do some research and make a few preliminary calls to get an idea of what changes (if any) need to be made to your loved one’s Medicare coverage. Preparing before the enrollment period begins will prevent you from scrambling to get the information and advice you need and making knee-jerk decisions. Try to complete at least one of these six steps each week, and you’ll be ready to tackle Open Enrollment in no time.
Caregiver Checklist for Preparing for Open Enrollment
- Make sure you familiarize yourself with the different parts of Medicare and how they work together. If you come across any terminology you don’t understand, brush up with the AgeWellPlanner provided by the National Council on Aging.
- Does your loved one currently have a Medicare Advantage Plan (also known as Part C)? Is that still working well? Make a point of opening all mail from the private insurance provider that arrives in September and October so you can be on top of any changes to premiums, deductibles, copays, formularies and provider groups.
- If your care recipient has a Medicare Supplement Insurance policy (also known as Medigap), make sure you pay attention to any premium increases. At some point, your loved one may need to consider switching to a different Medigap policy, dropping this policy or switching to an Advantage Plan.
- If out-of-pocket spending on hospital visits, prescription drugs and doctor’s appointments has increased in the current year because your loved one doesn’t have Medigap, Medicare Part D, or a Medicare Advantage Plan, now is the time to add up those costs and decide whether a different mix of coverage would be a more affordable solution. It’s also worth looking into public programs that can assist with covering health care costs and premiums, such as Medicaid, a state Medicare Savings Program or the “Extra Help” program.
- Go to the SHIP National Network website and look up the location of your local State Health Insurance Assistance Program (SHIP). SHIP counselors are usually located at Area Agencies on Aging (AAAs). However, counseling programs and AAAs may go by different names. For example, Florida calls their program the Serving Health Insurance Needs of Elders (SHINE) Program. They often put on public presentations each fall that cover changes in Medicare for the coming year and offer one-on-one counseling (appointments tend to fill up quickly). All SHIP services are offered free of charge. Now is the time to become best friends with your local SHIP counselors so they will remember you if you have a last-minute question.
- The other part of the equation is making sure you have up-to-date information about your loved one’s current health status and future needs/concerns. Are they due for an appointment with their primary care physician? Will they need a referral to see a specialist in the near future? Would adding dental, vision or hearing coverage be beneficial in the coming year? Make sure you have a current list of all their medications and know exactly why they are taking each one. If any of their prescriptions are brand name, ask their doctor or pharmacist if there are generic equivalents available. If not, be prepared to request an exception from your loved one’s Part C or Part D plan in case the brand-name medication isn’t part of their formulary.
Don’t Forget to Revisit Your Own Health Coverage
If you are a Medicare beneficiary yourself, do not forget to factor in your own open enrollment needs. Caregivers are notorious for looking out for everyone BUT themselves. Have you taken care of your preventive visits this year? Is your current coverage both sufficient and affordable? Use the above tips to create an Open Enrollment game plan for yourself as well. Perhaps you are turning 65 in the next 12 to 18 months. Your new contact at the SHIP office can assist you with weighing your own coverage options and ensure you do not miss any important deadlines.
Help yourself by making sure you are ahead of the curve. The holiday season may seem far off, but it ramps up quickly. Even twenty minutes of preparation here and there can save you hours of frantic work in November and December!