Tips For Medicare’s Tricky Open Enrollment Season

In the midst of the government shutdown and the launch of the Affordable Care Act (aka Obamacare) health exchanges, Medicare’s open enrollment season begins Tuesday October 15. That’s when the nation’s 50 million Medicare beneficiaries who are 65 or older can choose, switch, add or drop their 2014 health and prescription plan coverage. The open enrollment period is scheduled to end December 7.

Making the right choices might save you, or your parents, hundreds or thousands of dollars.

Why Open Enrollment Is Even More Confusing Now

Trouble is, open enrollment is always a baffling process. Compounded this year by the shutdown and Obamacare, “it’s definitely more confusing than normal,” says Diane Omdahl, founder and president of 65 Incorporated, a firm that provides Medicare advice and information.

A recent survey by Medicare prescription drug plan provider Express Scripts found that 86% of Americans who are in Medicare plans or will be Medicare-eligible in the next 12 months were confused about how healthcare reform will affect their Medicare prescription drug coverage.

(MORE: 4 Mistakes to Avoid When Enrolling in Medicare)

Problems With a Key Website

The shutdown is causing particular havoc for open enrollment because the Medicare Plan Finder, the government’s online guide to help beneficiaries select the right plans for them, “may not be up to date,” according to the site.

Under normal circumstances, Omdahl would be encouraging Medicare beneficiaries to start reviewing their options right now. “However, until the shutdown is over and the government is back up to speed, it might be best to postpone making any decisions,” she says. (If the government shutdown lasts for a while, there’s a chance open enrollment will be extended past Dec. 7.)

Still, it’s not too early to learn the basic do’s and — more importantly — don’ts to reduce this year’s confusion. I hope the following information and advice will help.

Medicare Enrollment Scams

First off, let me address the Medicare enrollment scams.

Some people over 65 have received fraudulent phone calls saying that, due to Obamacare, they’ll lose Medicare coverage or won’t be able to get “the required Affordable Act insurance card” unless they provided the caller with their Social Security number and other private information.

Others have gotten calls saying a new Medicare card has been mailed but they must reveal their checking account number so Medicare can deposit funds into that account, says Ross Blair, senior vice president of eHealth, whose eHealthMedicare.com and PlanPrescriber.comsites offer Medicare comparison tools and information.

Here’s the truth: The government won’t call you about your health insurance or to verify your Social Security number or bank information. If you’re a Medicare beneficiary, you can’t sign up for insurance through an Obamacare exchange; the Affordable Health Care marketplaces are for people under 65 without health insurance. So if you get one of these calls, hang up.

Changes for Medicare Plans in 2014

Now to what’s new for Medicare plans:

For 2014, many Medicare Advantage plans — the federally subsidized private insurer alternative to traditional fee-for-service Medicare — have quietly boosted monthly premiums, trimmed benefits, boosted co-pays and deductibles and cut back on supplemental services. (Some plans are eliminating coverage for out-of-network specialists.)

Medicare beneficiaries can buy Advantage plans instead of purchasing Medicare supplement insurance (known as Medigap) and Medicare Part D prescription drug plans.

Premiums for Advantage plans are due to rise an average of 5% in 2014 to $32.60 a month, according to the Centers for Medicare and Medicaid Services.

Meantime, some Medicare Part D prescription drug plans have jacked up premiums and the price you’ll pay for certain branded drugs. Although premiums are expected to increase 5.1% on average in 2013, according to Avalere Health, a consulting firm, half of the 10 most popular Part D plans will have double-digit increases.

Two pieces of good news regarding prescription drug costs: First, the infamous “doughnut hole” (the gap in coverage before a plan’s catastrophic coverage kicks in) will shrink by $80 next year. You’ll be in the hole for prescription drug costs between $2,850 and $4,450 in 2014; in 2013, the doughnut hole was $2,970 to $4,750. Second, the maximum Part D annual deductible will drop to $310 next year, from the current $325.

“If you have a lot of medication and out-of-pocket medical expenses, open enrollment is a critical period for you,” says Paula Muschler, operations manager for Allsup Medicare Advisor, which provides Medicare advice to consumers for a fee (typically $200 to $500).

Don’t automatically stick with the Medicare plan you have just to save the time and potential aggravation of shopping around. You could be costing yourself a bundle.