Janie Slaven: TONI SAYS: Know your Medicare Annual Enrollment options

Janie Slaven, The Times-Tribune, Corbin, Ky.
·3 min read

Oct. 19—Dear Toni:

I turned 65 in February and did not enroll in a Medicare Prescription Drug plan. I have been told that I must wait until October for Medicare's Annual Enrollment time. I need help now because I have been diagnosed with Parkinson's and my brand name prescription is expensive. I thought I could enroll at any time of the year. What can I do?

—James, Las Vegas

Hello James:

This year's Medicare Annual Enrollment Period (AEP) started on Saturday, October 15 and runs through Wednesday, December 7 (also Pearl Harbor Day). All plans will have January 1 as their start date.

This is the time when you can make changes to your Medicare Part D Prescription Drug plan or Medicare Part C Advantage plan. You can also initially enroll if you missed enrolling when you were first eligible, as you did, James, when you turned 65 in February.

Medicare's AEP is for enrolling in or changing a stand-alone Part D Medicare Prescription Drug plan or a Part C Medicare Advantage plan. The AEP does not, however, involve changing or enrolling in a Medicare Supplement per se. You can enroll in or change your Medicare Supplement plan, as long as you are enrolled in Part B, at any time of year.

Below are the changes that a Medicare beneficiary can make during the AEP:

—Enroll in a Medicare Part D Prescription Drug Plan

—Change from one Part D Medicare Prescription Drug Plan to a new Part D Medicare Prescription Drug Plan

—Enroll in a Part C Medicare Advantage Plan with Prescription Drugs

—Change from one Part C Medicare Advantage Plan (with or without Prescription Drug plan) to a new Part C Medicare Advantage Plan

—Return to Original Medicare and purchase a Medicare Supplement and enroll in a stand-alone Part D Medicare Prescription Drug Plan

—Return to Original Medicare only and enroll in a Part D Medicare Prescription Drug Plan

—Return to Original Medicare with no Part D plan. But don't forget there is a penalty for not enrolling in a Part D Medicare Prescription Drug plan when first eligible (unless you were previously covered by an employer's qualified health insurance plan).

For those who already have either a Part C Medicare Advantage plan with or without prescription drugs or a stand-alone Part D Medicare Prescription Drug plan, the Medicare AEP is the time to make sure your drug plan or Medicare Advantage plan still meets your needs, especially if you've experienced any changes to your health.

In fact, it is wise to verify each and every year that your prescription drugs are covered on your Part D plan, because plans can change their prescription drug formulary annually. If your prescriptions are not covered on your Part D plan for the new year, you may end up having to pay 100% of a prescription yourself.

Visit www.medicare.gov to view 2023 Medicare Part D and Medicare Advantage plans. The website has a tool for helping you narrow your search for new Medicare Advantage and Prescription Drug plans.

Because there are so many Medicare pitfalls, for both initial enrollment and the AEP, readers may want to review my Medicare Survival Guide Advanced book, which has a chapter that details many different situations — such as people who are still working past age 65 or who encounter a doctor not accepting their Medicare Advantage plan.

And if you're still confused about Medicare, you can visit ToniSays.com for information about upcoming Zoom webinars, including one on Wednesday, November 16 at 4 p.m. CST.

Toni King is an author and columnist on Medicare and health insurance issues. For a Medicare checkup, email: info@tonisays.com or call 832-519-8664. You can now visit www.seniorresource.com/medicare-moments to listen to her Medicare Moments podcasts.