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This year, open enrollment for Medicare began October 15 and closes December 7 for Part D and Advantage plans, shortening your shopping window by three weeks.  People buying their health insurance through the marketplace created by the Affordable Care Act can shop through open enrollment between November 1 and December 15. Their shopping window offers them only half as much time as last year to make this important decision.

2018 open enrollment creates more confusion and less consumer service.

In addition to shorter having less time to shop, consumers have seen less advertising and can expect limited consumer outreach this year. This doesn’t offer much help, especially in the current climate of confusion and uncertainty.

Shorter enrollment periods are also making it harder for insurers to meet demands, and marketplace consumers will deal with longer lines and slower service. The latest information, however, indicates that there are zero marketplace enrollees living in a county with no way to purchase affordable individual health coverage. But 2.9 million could be left with just one insurer to choose from. That’s out of more than 10 million enrollees total.

The Affordable Care Act.

Many people are still confused or unaware about the open enrollment start and end dates this year. In a Kaiser Family Foundation poll released this week, 85% of uninsured people surveyed either got the Nov. 1 date wrong or didn’t know it and 95% had the wrong end date.

Some things to remember include:

  • The website posted that it will be shut down every Sunday from midnight to noon for maintenance during open enrollment, except for Sunday, December 10.
  • Government spending on outreach and advertising has been slashed 90%. Funding for Affordable Care Act “Navigators” — unbiased people and groups trained to help people shop for coverage through the exchanges — has been cut by 41%. Expect less help and longer wait time from these State Health Insurance Assistance Programs (SHIPs).
  • Some health insurers sent renewal notices later than normal waiting for clarity about the rules for 2018. Not only have consumers had less time to research the information, but from all indication, change is still possible.

Use these links to get more information:

Part D and Medicare Advantage plans.

Most people currently enrolled in an Advantage plan have already received a packet of information about their 2018 coverage. This information most likely doesn’t include a list of participating doctors, nor will websites contain this information. This is mainly because there’s too much change in the air.

The most common changes to Medicare Advantage plans include prescription drug formulas, the premiums you pay each month, and the percentage or dollar amount the plan pays toward your medical expenses as you incur them.

As a first word of caution, if you’re satisfied with your present coverage, review it carefully to see if anything important has changed. If this is your first experience shopping for an Advantage plan, don’t put off your doing your research and finding the right provider. Here are some suggestions:woman sitting on the hospital bed

  • Prescription drugs. Your packet of information for 2018 coverage should include a list of drugs. Check the drugs you currently take against this list. Then get your 2017 insurance coverage information and do a side-by-side check to see if any of the drugs you take have changed tier level or availability. If there have been changes or you can’t find your prescription drug, this should raise a red flag. Understand how your plan covers brand-name versus generic drugs. You’ll also want to Review Part D.
  • Primary care physician. Your plan or your physician may have made changes relative to their network participation. Most of the time, your primary care physician’s office will not be the source for confirming as to whether or not your physician is still in your plan network. Check this information directly through your provider. If there is another physician in your PCP’s office, ask if that doctor is also in your plan’s network. You could be charged for receiving services for out-of-network care if you receive services from a doctor in the same office who is not included. This happens, with both primary care physicians as well as specialists. Be sure your understand the network system.
  • Physician specialists. Review the list of specialists in your area. When your primary care physician recommends that a specialist be brought in for your care, his choice may or may not be on your list of network options. Always check.
  • Premiums. Check your premium rates against any increase or decrease in benefits.
  • Your health. If you’ve experienced any health issues that have changed your level of required care, you should to take a close overall look at your plan.
  • Your Advantage Plan provider. Whether you purchased your plan on-line or sat down with your agent, now is the time to seriously revisit each. Remember, both are dealing with more clients and are trying to explain the confusing and continually changing Medicare law. providers and consumers don’t have much time.

What should you do about open enrollment?

Don’t put taking off taking care of this responsibility. If you have an on-line or in-person agent, read the material they sent you and contact them immediately. If you currently have an Advantage plan and don’t do anything, you will automatically be ‘signed up’ for 2018 coverage. Make sure the coverage continues to fit your needs. If you’re new to this and don’t know where to go, ask a friend who’s satisfied with their coverage. A friendly conversation goes a long way. Read the advertisements you’ve received. Go on-line and do some research. Of course, we’re available to assist with your concerns and questions.

Anything else? Sure…if you have a parent, loved one or friend who is dealing with this issue, check on them. They might really appreciate it.

What’s the bottom line?

If you have questions about Medicare Open Enrollment, we’re here to help you find answers. As your CPA firm, you’ll find that we’re concerned and available to assist as you face the many important milestones and steps in your life. That’s what we do.

We establish and maintain a personal and business relationship with our clients. We know that Your LIFE is your Business and Your BUSINESS is Your Life, and we take both seriously.

Contact Melanie Radcaliff CPA, Inc.
Call 479.478.6831 or send us an email

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