Q&A: Medicare Open Enrollment

Medicare open enrollment starts today and runs through Dec. 7th.

Each county has multiple plan options for Ohioans to choose from, so ideastream health reporter Lisa Ryan sat down with All Things Considered host Glenn Forbes to answer questions on the process, potential pitfalls and more.

Who does Medicare open enrollment affect?

Everyone who is currently using Medicare needs to go online review their plan. Each plan changes each year, so you need to review it to make sure it works for you still. It affects about 2 million people using Medicare in Ohio in Ohio is actually the sixth most Medicare populated state.

I talked with Cynthia Walker from the Benjamin Rose Institute on Aging and she recommends that people opt in for the most coverage.

“We may be healthy today but who knows what the future holds. We're older, things happen and we get sick,” Walker says.

And if you try to add coverage outside of open enrollment, you could be penalized. So what she's saying is, assume that you will get sick, eventually, and that you'll want to have the most amount of coverage that you can. 

What should Medicare recipients be looking for when they review their plans?

State officials say cost, coverage and convenience are the most important. What that means is that each plan is a different cost, so you want to make sure that it works with your budget. People who are on Medicare oftentimes are on a fixed income so they need to have it fit within their budget. You want to check to make sure that cost hasn't changed or, if it has, it still works with that budget.

Also, when you're reviewing the plan, even though your cost might still work within your budget, there might be a plan out there that works better for you and that is more cost effective and still gives you the coverage that you need.

When it comes to coverage you want to make sure that your doctors remain in your network that your prescriptions are still covered because if your plan changes and you realize that you can't get that medication you need, if you try to change it outside of this open enrollment period, you can be penalized for that.

There's the traditional Medicare offered by the federal government. Can seniors also choose a plan offered by private companies?

Yes, it's called the Medicare Advantage plan. It actually combines a lot of the things that you find in the traditional Medicare coverage all into one plan.

Chris Reeg from the Ohio Department of Insurance says there are pros and cons of each of these different plans. Traditional Medicare opens up a lot more options for doctors. With Medicare Advantage you have to make sure those doctors are in your network depending on who your provider is.

But the benefit of signing up for Medicare Advantage is it includes everything you need, says Chris Reeg.

“So that one card in your wallet is going to cover the hospital the medical and the drug so there's no need for any other insurance policy,” Reeg says

And Republicans typically favor this private-sector version including President Donald Trump. He was in Florida earlier this month signing an executive order making changes to the Medicare Advantage plan. He'd like to see it equal in cost and coverage to traditional Medicare. The executive order is still being studied by health officials, according to The Washington Post, so it does not effect this year's Medicare plans. 

And Lisa, you know unfortunately, we've all heard the stories. We know that our seniors can be vulnerable when it comes to scams. Are there any Medicare-based scams out there?

Yes there are, and state officials are warning about these scams. You'll get a call that says it's the Social Security office and that you have to call a specific number. It's a recorded message and they'll give you a number to call. And that is a scam. You don't want to call that number, you want to check to make sure what the Social Security office number is. Or you could go there even in person, if you feel like they might be trying to get a hold of you. But if you were to call that number, they ask for your Social Security Number, then they can steal your identity if they have that.

Cynthia Walker who we talked to, she says if it's not a call that you made then you want to make sure that you're not giving out your personal information. So if anyone is calling you or coming to your home to ask for your information, that is not a government official; they'll mail you information.