What You Should Know About Fall Medicare “Open Enrollment” v. Obamacare

It’s that time of year for Medicare’s annual “open enrollment” period, running from October 15th to December 7th. It’s also the first-ever enrollment period for coverage under the Affordable Care Act (ACA), popularly known as Obamacare.

Although the two programs are quite separate, the timing of the enrollment overlap has caused a lot of confusion among seniors and their families. To clear up some common misperceptions, the National Association of Professional Geriatric Care Managers (NAPGCM) offers these clarifications about Medicare’s open enrollment and the ACA:

 If I’m on Medicare, do I need to buy more or different health insurance to comply with the ACA?

People on Medicare have insurance and ARE NOT required to get any additional coverage beyond what they already have. The ACA only requires people who are currently uninsured to buy coverage or pay a penalty.

Under the ACA, do I need to go online to re-enroll in my traditional Medicare, Medicare Advantage plan or Medicare prescription drug plan?

If you are enrolled in Medicare, you DO NOT need to re-enroll or take any additional action. If someone tells you to, it is likely a scam. Stay away.

Are the new state health care exchanges and the new federal health insurance marketplace at http://www.healthcare.gov for seniors on Medicare?

The state and federal marketplaces are to help people without insurance find coverage. The website for seniors and other Americans enrolled in Medicare is http://www.Medicare.gov. You can go to this site to check your enrollment, find out about your coverage choices and prescription drug plans that are available to you, and find answers to other questions you may have about Medicare or private Medicare supplemental insurance, sometimes known as Medigap.

When is the open enrollment period for Medicare?

The Medicare open enrollment period runs from October 15th through December 7th. It is the one time of year that seniors and others on Medicare can change their plans and/or prescription drug coverage during this time by visiting http://www.Medicare.gov. Enrollment for the ACA started October 1st and is entirely unrelated to Medicare Open Enrollment.

There are some exceptions to the Medicare open enrollment period for individuals dealing with specific circumstances. If you have questions, contact Medicare or a professional adviser for guidance.

With all the political uncertainty in Washington, is my best course of action just sticking with the Medicare plan I have?

Your enrollment decisions need not be influenced by current events. If you are happy with your current coverage, stick with what you have. But it makes sense to regularly review your options during the annual Medicare open enrollment period. For example, if your health has changed in a way that requires you to take new or more prescription drugs, comparing your current Medicare Part D prescription drug plan to other available options might save you money.

Also, a new study finds that some Part D plans are raising their rates for 2014 by as much as 55 percent, while others are dropping their rates by as much as 38 percent. So comparing rates makes sense. Before making a change, discuss it with a trusted family member, friend or professional advisor.

What should I do if I’m contacted about signing up for a health insurance plan?

According to Medicare officials, the Medicare open enrollment period is a time for higher risk of fraudulent activities. They remind us that it is against the law for someone who knows that you are on Medicare to try to sell you a Marketplace plan. DO NOT share your Medicare number or other personal information with anyone who knocks on your door or contacts you uninvited to sell you a health plan.

The National Association of Professional Geriatric Care Managers (NAPGCM) was formed in 1985 to advance dignified care for older adults and their families. Geriatric Care Managers are professionals who have extensive training and experience working with older people, people with disabilities and families who need assistance with caregiving issues. For more information or to access a nationwide directory of professional geriatric care managers, please visit http://www.caremanager.org.

About Deborah Fins Associates, PC
President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified geriatric care manager. Drawing on more than 30 years of professional experience in geriatric care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

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