With less than a week until the end of Medicare Open Enrollment, it’s time to choose your plan if you haven’t already.
It can be confusing to sort through all of the options and requirements when picking a plan for the new year. Keep these 6 things in mind when enrolling for 2016.
- First, and most importantly—open enrollment ends December 7, 2015. You will need to make any changes to your Medicare health plan or prescription drug plan before then. If you want coverage for your prescriptions, you will either need a Medicare Advantage plan that offers drug coverage, or a Medicare Part D plan.
- You don’t necessarily need to change your plan… If you’re happy with your current coverage and the same plan is being offered next year, you don’t have to do anything. However, you will still need to double check that your plan is available in 2016 through the Medicare.gov plan finder.
- …But it’s always worth it to check. Your coverage may be changing, or you may be taking different prescriptions than when you chose your plan last year. Again, the Medicare.gov plan finder is a helpful tool that lets you compare your total yearly cost for all of your prescriptions. You can even choose to see your total cost at your preferred pharmacy.
- You may pay more in 2016 for Medicare health coverage. Medicare Part B (your health coverage) premiums will increase by up to 52% for 30% of you, from $104.90 to $159.30 per month. You’re exempt from the increase if you have your premium paid directly out of your Social Security check—and luckily, this should apply to the remaining 70%. Why the difference? There’s no cost-of-living increase for Social Security next year. Find out more.
- And you’ll definitely pay more for prescription coverage. Medicare Part D (prescription coverage) deductibles are also going up, and this applies to everyone. Deductibles will increase $76 in 2016, from $147 to $223.
- Be careful where you fill your prescriptions. 85% of Medicare Part D plans will have a preferred pharmacy network in 2016. This isn’t new—it’s about the same number as this year—but it can be inconvenient, and cost you extra if you aren’t aware. With a preferred pharmacy network, you can still fill at any pharmacy you choose, but you’ll pay significantly more out-of-pocket at a non-preferred pharmacy.
- The coverage gap is changing again. This is good to remember when considering whether your prescriptions will put you into the “donut hole” before the end of 2016—and whether you’ll spend enough to hit catastrophic coverage (where your prescription prices will go back down). In 2016, the coverage gap will start once you’ve spent $3,310 on your prescriptions, and you’ll need to spend $4,850 to hit the out-of-pocket limit. While in the gap, you’ll still receive a 55% discount on brand-name drugs—and the 50% portion of the discount will still count towards getting you out of the donut hole.
- Your new coverage will begin on January 1, 2016. Even after you choose your coverage for 2016, you will continue to use your 2015 plan until the end of the year.
- You may get a second chance to change your plan. Between January 1 and February 14 in 2016, you may choose to switch to an Original Medicare plan—but only if you currently have a Medicare Advantage plan. If you switch, you’ll also have the opportunity to join a Medicare prescription coverage plan (since Original Medicare plans do not offer drug coverage).
If you have any questions, or would like to enroll over the phone, call 1-800-MEDICARE (1-800-633-4227). You can also review your plan, enroll or change your coverage, or find answers to your questions online at Medicare.gov.