Medicare Advantage Open Enrollment Period Starts Early
Check Your Options Now
Madison, WI—Insurance Commissioner Ted Nickel reminds Wisconsinites that the Medicare open enrollment period begins on October 15 and ends December 7 this year. Medicare open enrollment allows consumers to look at their existing Medicare drug and medical plans and decide whether or not to keep the coverage they have or switch to a new drug or Medicare Advantage plan. Consumers should review their Medicare Advantage and prescription drug plans' coverage for 2016 now to see if those plans still meet their needs.
"It is important to spend a little bit of time and do an insurance check-up every year. The plan you have this year may not be exactly the same for 2016," said Nickel. "Plans may change their premiums, deductibles and coinsurance. They may also add or drop physicians and hospitals from their networks or change which drugs they cover."
People with Medicare are receiving information now from their plans about changes for 2016, including changes to premiums and cost-sharing. They should study this information carefully and determine whether staying with their current plan for 2016 is best for them. During the open enrollment period from October 15 to December 7, 2015, people with Medicare can sign up for any Medicare Advantage or prescription drug plan offered in their area or switch to original Medicare. The federal government has a very useful Web site (Medicare.gov) that will provide information on the Medicare Advantage plans available in an area. They can sign up for a plan from the Web site or contact the plan directly.
When considering a change in Medicare coverage, it is very important to evaluate the cost-sharing provisions of any new plan. Medicare Advantage plans have different deductibles and copayments and those differences can be quite significant. Generally, the higher the cost-sharing, the lower the premium charged by the plan. However, should an illness occur, out-of-pocket expenses will be greater.
Remember, people with Medicare do not have to change plans unless they choose to.
The cheapest policy may not be the best option. Some things that should be considered when deciding to change or keep one's current plan include:
- Will the plan allow you to see the providers you want?
- Will your current doctors accept your coverage?
- Are there any additional benefits offered? What is the additional charge for those benefits?
- Will the plan cover the prescription drugs you are currently taking?
- What are the benefits that are excluded? Would those benefits be covered under an original Medicare supplement policy?
- What is the total cost to you, including premiums, coinsurance, copayments, deductibles, or other out-of-pocket expenses?
- How often and by how much can the plan raise your premiums?
- If you have a specific health condition, is one type of plan better suited to provide the services you need?
Generally, plans that offer you more freedom in choosing providers or that cover additional benefits will cost you more, either in premiums or out-of-pocket expenses.
There are a number of places that consumers can visit for more information about Medicare, their options, and assistance. The Office of the Commissioner of Insurance (OCI) also has a number of resources. Publications including
Medicare Part D - Things to Know Before Signing Up and
Wisconsin Guide to Health Insurance for People with Medicare are available on OCI's Web site. Consumers can also go to Medicare's Web site at
Medicare.gov for information on this important topic.
To compare Medicare Advantage plans or to find out what plans are available in your area, you can:
- Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, or visit
Medicare.gov on the Web.
- Contact the Medigap Helpline at 1-800-242-1060 (Medigap Helpline) or on the Web at
Although Medicare Advantage plans are regulated by the federal government, the Wisconsin Office of the Commissioner of Insurance still regulates insurance agents who sell these products and their actions. If you or someone in your family is a Medicare beneficiary and you have questions regarding agent activity or wish to file a complaint involving an agent, contact OCI at 1-800-236-8517. Further information and complaint forms are also available on the OCI Web site:
Created by the Legislature in 1870, Wisconsin's Office of the Commissioner of Insurance (OCI) was vested with broad powers to ensure that the insurance industry responsibly and adequately met the insurance needs of Wisconsin citizens. Today, OCI's mission is to lead the way in informing and protecting the public and responding to its insurance needs.