Vol. 14, Issue 20 – October 5, 2015
Dear Marci,

When does Fall Open Enrollment start, and how can I make sure I’m prepared? This is the first year I’ve had Medicare, so I don’t know what to expect.

– Zoe (Boise, ID)


Dear Zoe,

Fall Open Enrollment runs from October 15 to December 7 and is the time during the year when you can change the way your Medicare health coverage is delivered. Specifically, you can decide whether you receive your coverage through Original Medicare and a stand-alone Part D plan OR through a Medicare Advantage Plan. You can make as many changes as you like during this period, but only the last one will take effect. Any changes you make will become effective starting January 1, 2016.

Even if you decide you don’t want to change your coverage, it is still a good idea to take a look at your current health care coverage and see if it will continue to meet your needs in the coming year. Sometimes plans change their provider networks, policies, drug formularies, and/or preferred pharmacies, and sometimes your health care needs change as well.

There are two important things you should do during Fall Open Enrollment:

  1. First, review your current health and drug coverage. If you have Original Medicare, take a look at next year’s Medicare & You handbook to know your Medicare costs and benefits for the upcoming year. If you are dissatisfied with your Original Medicare coverage, you can make changes during Fall Open Enrollment.

If you have a Medicare Advantage Plan or a stand-alone Part D drug plan, you should receive an Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC) from your plan. Review these notices for any changes in the plan’s costs, benefits, and rules for the upcoming year. If you are dissatisfied with any changes, you can change your Medicare Advantage Plan or stand-alone Part D plan during Fall Open Enrollment. If you want to switch from a Medicare Advantage Plan to Original Medicare you can do that as well at this time.

Remember: even if you are satisfied with your current Medicare coverage, it’s smart to look at other Medicare options in your area that may better suit your individual needs in the upcoming year. Particularly if you think that you may need specific health services or drugs in the coming year, you should make sure your health insurance will cover them.

  1. Next, think about costs. It is important to look at the different premiums and deductibles associated with the plans you are considering. Some Medicare Advantage Plans have an additional premium on top of the Part B premium of $104.90 that most beneficiaries pay each month. Similarly, some drug plans have annual deductibles, while others do not. This is all to say that it is a good idea to compare all aspects of the plans you are considering. For example, even if you are satisfied with your current Medicare Advantage or Part D plan, you should check to see if there is another plan in your area that will offer you the same or better health and/or drug coverage at a more affordable price or have fewer coverage restrictions. Research shows that people with Medicare prescription drug coverage could lower their costs by shopping among plans each year.

Take action! Create a list of all the health care providers you see, prescription drugs you take, and pharmacies you use. Contact your SHIP for one-on-one assistance with reviewing your health and drug plan options for 2016.

– Marci

Health Tip
Just as some people are lactose intolerant and do not gain health benefits from drinking milk, a new study has found that the same may hold true for omega-3 fatty acids. These fatty acids are found primarily in fish, and you may have heard of them in relation to their benefits for heart health. Scientists initially posited the connection between fatty acids and heart health by studying Inuit populations, which have low levels of heart disease and primarily eat foods rich in omega-3 fatty acids. Currently, 10 percent of people in the United States take an omega-3 supplement in hopes of lowering their risk of heart attack or stroke. Despite this, there has been no noticeable change in the number of heart attacks or strokes among people taking these supplements. The new study suggests that this may be because only Inuit people have the necessary gene variant that allows them to metabolize higher levels of fat in a beneficial way. Going forward, scientists hope to use this new information to learn why fatty acids have not been as beneficial for non-Inuit populations. They also aim to gain new insights about how fat affects our health in general.
Need to Know
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