Did you realize that there’s only a specific period where you can change your Medicare coverage? Medicare’s Annual Enrollment Period (known as AEP) is when you can enroll in a stand-alone Medicare Part D plan (which covers prescription drugs) or a Medicare Advantage plan. It’s also the time to make any necessary changes to your existing coverage.
Health Plans of NC, Kelly Quinn
If you live in North Carolina, our dedicated and local Medicare agents can answer your questions. They know the ins and outs of AEP and can help you understand all your options regarding Medicare health plans in North Carolina.
Medicare’s AEP takes place each year from October 15 to December 7. During this time, you’re able to make several changes to ensure you’ve got the best Medicare coverage for your needs, including:
Switching from Original Medicare to a Medicare Advantage plan.
Switching back to Original Medicare from a Medicare Advantage plan.
Switch to a different Medicare Advantage plan that better suits your health needs.
Making the switch to a Medicare Advantage plan to ensure it includes prescription drug coverage.
Enrolling in a Medicare Part D prescription drug plan.
Switching to a different type of Medicare Part D prescription drug plan that better suits your needs.
Removing prescription drug coverage from your plan.
If you’re looking to take advantage of the Medicare AEP to make necessary changes to your health insurance plan, a few key steps are important to ensure you get the plan that’s right for you.
If you’re thinking about enrolling in a Medicare Advantage plan during the Medicare AEP, the first step is to check your eligibility. You should be eligible if you already have Medicare Part A and B. Check if your plan is available in your area, as some plans only apply to specific counties in North Carolina. If you’re just interested in enrolling in a stand-alone Medicare Part D plan for your prescription drug needs, you must have Medicare Part A and/or Part B. Like Medicare Advantage, you’ll need to check if the plan you want to enroll in is available in North Carolina.
Before deciding what type of plan is suitable, you must review your existing Medicare coverage to check whether it is adequate for your health needs. Consider the types of healthcare services you have used recently, and determine whether your coverage meets those needs and is appropriate for your budget. Suppose you’re enrolled in Original Medicare Part A and Part B. In that case, it may be an excellent option to enroll in a plan that offers additional benefits that aren’t typically included, like Medicare dental and vision. For example, some Medicare Advantage plans include coverage for ongoing dental care or routine visits to check your vision. It’s also important to realize that Original Medicare doesn’t include coverage for prescription drugs. So, you must purchase a separate Medicare Part D prescription drug plan or consider taking out a Medicare Advantage plan that offers prescription drug benefits. If you’re already enrolled in a Medicare Part D plan or a Medicare Advantage plan, reviewing the Evidence of Coverage (known as the EOC) is a good idea. You can also review your Annual Notice of Change documents, typically sent out to you just before the Medicare AEP begins. These documents can give you important details about your existing plan’s coverage, including any changes to costs or benefits for the following year. You may also need to verify that your prescription drug coverage (if not Medicare Part D) is known as ‘creditable coverage’. This means the coverage is expected to pay as much as standard Medicare prescription drug coverage. If not, you may want to enroll in Medicare Part D. If you go without creditable coverage for over 63 consecutive days after your Initial Enrollment Period, you may be subject to enrollment penalties if you sign up later.
If you have existing health insurance, such as retiree or veterans’ benefits, thoroughly check what additional services are included. In addition, it’s worth getting in touch with your insurance company and discussing how your insurance works in collaboration with Medicare. With some insurance plans, you may be required to enroll in Medicare to maintain eligibility. Our North Carolina Medicare agents can help answer any questions about combining Medicare with existing insurance. In some cases, enrolling in a Medicare Advantage plan or arranging a stand-alone prescription drug plan can mean you lose access to specific coverage under your existing insurance. Ensure you understand the implications of enrolling in Medicare before taking action. Talking to an experienced health insurance agent in NC can help you determine the best option.
To help ensure that you’re getting the best coverage for your budget, review your current health costs and think about what kind of health needs you’ll likely need in the future (and the associated costs). Even if you’re happy with your current level of coverage, the AEP is an excellent time to compare prices to help ensure you’re getting the best coverage for your budget. Medicare plans can often vary widely regarding premiums and benefits, so you may find you can access better coverage at a more affordable price. Our Medicare agents in NC are passionate about helping people find the perfect coverage at a cost they can afford. It’s essential to remember that there is a separate monthly premium for most Medicare Advantage plans for coverage. This is in addition to any premiums you’re paying for Medicare Part B.
To help you narrow down your options and find the right plan for you, look at each of your plan choices and consider the following.
How important is it for you to be able to see your current primary care physician or specialist? If you’re comparing plans, review the provider networks to determine if your preferred provider is included in the plan’s network. If they’re not listed, you’ll pay more to see your preferred provider.
Be sure to consider the cost of monthly premiums and the copayments and deductibles. Often, a plan with a lower premium can mean you’ll end up paying more for using services, which can cost you more in the long run. Also, check out the out-of-pocket maximum to establish how much you’ll have to pay.
Find out if the plan covers all the prescription drugs you’ll likely need. Each plan should provide a list of the covered medicines, with many separated into tiers that offer higher or lower copayments. This means the cost of the same drug may vary depending on the plan you choose.
All Medicare Advantage plans, and Medicare Part D plans for prescription drugs are rated for customer satisfaction and quality. The rating scale is from 1 to 5, with a 5-star rating indicating excellent quality.
Getting the right Medicare coverage shouldn’t be complicated. Assessing your coverage each year during AEP means you can access the right coverage for your needs and budget. Why not compare plans online or contact our agents to learn about the different types of Medicare plans in North Carolina?