Oct 27, 2019 5 min read

Medicare’s annual open enrollment period is underway.

The period began Oct. 15 and will run through Dec. 7. During this time, Medicare beneficiaries have the option to compare or switch their Medicare Advantage plans and/or Part D Prescription Drug plans. Open enrollment occurs once a year, so it’s important that Medicare beneficiaries take advantage of this opportunity to ensure that they have a plan that meets their needs.

It’s a good idea to review your health insurance options during each open enrollment period. And it’s important to find the right plan to fit your healthcare needs and budget.

Here are some things to look at when comparing your plan:

Premium prices:

• Plan prices may or may not increase for the upcoming year. Check to make sure your plan is still affordable.

Deductibles:

• To fully understand your costs, check to see whether your plan has a deductible associated with it.

Cost-sharing changes:

• Plans can change the copayments and coinsurance associated with services yearly.

Network changes:

• It is especially important to check that your preferred doctors, providers and hospitals will be in-network for the upcoming year. Seeing in-network providers generally costs less than seeing out-of-network providers. Provider networks can change yearly.

Covered medications:

• It’s important to double-check to make sure all of your current prescription drugs are covered on the plans formulary, and what the costs of your medications will be for the year. Most plans use a five-tiered cost-sharing design; medications in each tier can have different out-of-pocket costs, ranging from set copayments to sharing a percentage of the cost with the beneficiary.

Preferred pharmacies:

• Some plans offer beneficiaries lower cost-sharing requirements if they fill their prescriptions at selected network pharmacies. It’s important to see whether the pharmacy you are using is considered “preferred” to ensure you are getting the best possible price for your medications.

Medication restrictions:

• Some plans require beneficiaries to get prior authorization before they will cover certain drugs, engage in step therapy (requiring patients to try a lower-cost drug before paying for an expensive medication) or impose quantity limits, where they can limit the amount of medication a beneficiary can buy at one time. It’s important to know whether your medications have any restrictions on them.

It makes sense to take a few moments and sit down with an experienced APPRISE counselor to look at your current coverage and see how it might be changing for the upcoming year. APPRISE-certified counselors provide free, unbiased, accurate information about Medicare.

The APPRISE program is set up to help answer your questions. If you are interested in having a free, confidential plan comparison done, contact your local Area Agency On Aging’s APPRISE Program to meet with a certified Medicare counselor to discuss your needs.

The APPRISE program has scheduled the Medicare enrollment centers listed below. To make an appointment, contact the enrollment center most convenient for you.

Applicants must bring pertinent insurance cards, including the Medicare card (red, white and blue), zip code of their pharmacy and a list of their prescriptions, including the dosage and frequency taken.

Washington center:

• Southwest Pennsylvania Area Agency on Aging Inc.; 150 W. Beau St., Suite 216, Washington 15301; Tuesdays through Dec. 4, 10 a.m. to 3 p.m.; by appointment only; 724-228-7080.

Mon Valley center:

• Southwest Pennsylvania Area Agency on Aging Inc.; 305 Chamber Plaza, Charleroi 15022; Wednesdays and Thursdays through Dec. 6, 9:30 a.m. to 2:30 p.m.; by appointment only; 724-489-8080 or 1-888-300-2704, Ext. 4438.

Greene County center:

• Southwest Pennsylvania Area Agency on Aging Inc.; 93 E. High Street, Waynesburg 15370; Mondays through Dec 3, 9:30 a.m. to 2:30 p.m.; by appointment only; 724-852-1510.

Fayette County center: Southwest Pennsylvania Area Agency on Aging Inc.; 137 N. Beeson Ave., Suite 107, Uniontown 15401; Wednesdays through Dec. 5, 9:30 a.m. to 2:30 p.m.; by appointment only; 724-430-4603.