Medicare Open Enrollment takes place annually from October 15 to December 7. During this time, eligible individuals can review and adjust their current Medicare plans to better meet their needs for the coming year. Although this process may appear straightforward, the various deadlines, changes, and pressure can make it feel overwhelming for many.

To simplify things, here are some common mistakes beneficiaries make during Medicare Open Enrollment, along with strategies to help you avoid them.

Mistake #1: Assuming Your Current Health Care Coverage Will Stay the Same

Each year, beneficiaries enroll in either Medicare Advantage or a stand-alone Part D prescription drug plan. Changes to these plans happen frequently, which can impact your:

• Monthly premiums
• Deductibles
• Coinsurance
• Copayments
• Pharmacy networks

These changes could lead to a significant increase in out-of-pocket costs for the next year.

Solution: To avoid any surprises, review the Medicare Annual Notice of Change (ANOC). This document, sent to your home each September, details any changes in coverage, costs, or service areas that will take effect on January 1 of the following year. If you notice any undesirable changes or have questions about the ANOC, take the time to contact a licensed agent to discuss your options and make necessary updates.

Mistake #2: Delaying Your Decision

With a limited time frame to review new coverage updates before making your annual selection, it’s essential to set aside dedicated time to understand your options.

Also, consider your potential future medical needs and expenses in relation to your budget. Ensure you have enough time to complete the process thoroughly and enroll in a plan that meets your healthcare needs for the coming year.

Remember: Procrastination can leave you stuck with an unsuitable plan that’s difficult to change, and you might even face late enrollment penalties.

Solution: To avoid rushing your decision, give yourself ample time to review the ANOC. Compare your current plan with any new options available for the next year, paying attention to differences that could affect your coverage. Make a list of your current and anticipated medical expenses. Lastly, consider scheduling an appointment with a licensed insurance agent who can help you evaluate your options.

Mistake #3: Choosing Your Plan Based Solely on Monthly Premiums

While opting for a lower premium might seem appealing, it isn’t always the best way to save on medical expenses in the long run. It’s essential to consider all potential costs when selecting your plan, including:

• Premiums
• Deductibles
• Prescription drug copays

To highlight the significance of evaluating all these factors, consider that if you focus only on the monthly premium, you might pay less than $20 a month but end up spending over $300 on prescriptions that your plan doesn’t cover.

Solution: Reduce the risk of incurring unnecessary out-of-pocket expenses by visiting the official Medicare website or calling your licensed agent. Make sure to sort the available plans by “lowest drug + premium cost” to find options that provide the lowest overall annual out-of-pocket expenses.

Mistake #4: Assuming Your Part D Plan Always Provides the Best Prices for Prescriptions

Each Part D plan has its own formulary, which means that your copay or coinsurance for the same medication can differ significantly between two plans. Therefore, it’s wise to check with your agent to see if you can find the same medication for a lower price. 

Mistake #5: Overlooking Your Plan’s Annual Notice of Change (ANOC)

Building on the previous point about reviewing your coverage, before the Annual Enrollment Period (AEP) begins, you will receive an Annual Notice of Change (ANOC) from your Medicare Part D or Medicare Advantage plan. This document outlines any changes to your plan. It provides details about modifications in benefits or costs for the upcoming year, which could impact both your healthcare and your budget.

Make sure to familiarize yourself with what to look for in your ANOC, including questions that can help you understand the plan changes and their implications for you.

Need help? Call Health Plans in Oregon: 503-928-6918. Our assistance is at no cost to you.