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Medicare Advantage Open Enrollment Primer

From January 1 to March 31 is open enrollment for the Medicare Advantage Program. If you didn’t like the selection you made during Medicare Open Enrollment on October 15 to December 7, you are able to change your MAPD plan, which comes with Part D, during this time. Every year you get an annual notice of change letter from your healthcare carrier. If you don’t read that, you might not realize what the changes are until they go in effect on January 1. If your drug prices have changed, or your network provider has changed, this allows you to correct that. Dan Redler, CEO, and Dan Leary, COO, of We Speak Medicare explain why the enrollment period exists and how it works.

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*The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.

The following podcast is provided by we speak Medicare and answers for elders radio, and welcome back to answers for elders radio, and we are here with Dan and Dan from we speak Medicare, Dan Reddler, the CEO, and Dan Leary, the CEO, and I’m so glad to have you both back on the show and you guys have been educating us and our listeners all about Medicare, which is so complicated to say the least. So thank you for being here, guys. Thank you for having us. You know you we just been through what we call the annual enrollment period. That ended on December seven correct. So it’s interesting because now there’s a little break time, but come January first there’s some news stuff that comes up. That is called the Medicare advantage open enrollment program and I have no clue what the difference is. So before we even start, tell me where we’ve been and where we’re going. So we just came out of, yeah, out of the annual enrollment period, or a EPS, and what that is is that is a time in which all of the consumers that are on Medicare can change their plan to either go back to straight Medicare changed to another comedicare advantage plan, go to a Medicare supplement. It allows them to make that change. Okay, and so that is the freedom move about the cabin got of atmosphere. That ends on December seventh and when that ends, no more plan changes. You are locked in for the rest of the year, for the rest of the coming coming here, so until the following open and open enrollment period. Yes, the annual enrollment period the following year. Got It okay. So so then what happens then? The Medicare advantage program which is January first. Tell me about that. So a few years ago Medicare opened what they called the open enrollment period, and what that was intended for is someone made a choice during ATP that they didn’t like. They are now have the opportunity from January one to March thirty one, to change that Medicare advantage prescription drug plan, also known as an MPD, right to another Medicarey. That’s also called the part d correct. It comes with a part D Y. Got it okay, and some don’t. But you can switch from, okay, I’m APD to M APD during this time of the year. Okay, so January one to March thirty one. If for some reason you didn’t like your selection, you can switch to another plan. You can go back to original Medicare if you want it, and grab a prescription drug plan to go along with it, because you have to have something tied to it right, prescriptions, right, and you’re allowed to do that if you didn’t make a selection that you liked during that annual enrollment period. That happened from Otie and December Sep okay, okay, a lot of people don’t realize that. Every year they get an annual notice of change letter from your carrier. Right. A lot of people haven’t read it and they don’t realize what the changes are in charge Yanuary and then they say, Oh, my drug prices, cheese, and even though I renewed or I did this, I didn’t realize that this is what, kid is going to happen. You automatically renews and then when during that period, you have a a chance to correct that. Wow, that’s a big thing. It’s a very big thing, and you know it’s true. How how many of us read the stuff that comes from insurance? You know, it’s like whatever, it’s marketing it’s this or that and we kind of it goes in the round file, as they say. And and yet a lot of these things are really, really critical that we could be their seniors that may be paying for things that they don’t need, or they may need more coverage on other situations that they may have signed up for that they didn’t realize that they don’t have. I’m assuming is that correct? Yes, and and Dan was talking about a really good point is yeah, you know, you get your annual notice of change on an annual basis. Uh Huh, it’s really thick. Sure, and so the consumer most of the time doesn’t look at that and now feels, well, you know, my plan is working and it didn’t read the hand will notice of cash and they don’t realize that something will change, either in the formularity that they’re with their prescriptions, or maybe their doctors not going to be in the network anymore, or there is some changes. And this is a really great opportunity for folks to say, you know, I really didn’t like how this change. Sure, I’d like to go look for something else. And that’s what the open enrollment period allows them to do. If they didn’t make their selection or they didn’t like the selection they made during a EP, the annual enrorollment period. So I’m going to ask you a real obvious question, but I want to really I think we need to make emphasize this. It’s like who needs to use the open rollment period? Who needs to to go there? You know, we were suggesting earlier that everybody review your anyway. So during this period, if you have any doubt that you automatically enrolled or some companies have mapped people from one one plan that they’re subsets and setting to a new were a plan that he’s good cost more, they should call in do a through a review. Absolutely, because this, this is a gift. It used to be that you couldn’t do this. We only been the last couple of years at that seniors are allowed to do it. Well, and it’s an important thing too, because you never know if there’s going to be changes after the first year and you’ve already enrolled in into a company, it may be, you know, detrimental to you unless you really sit down and take a look at what specifically do I have and what kind of coverage and, obviously, to our listeners out there, make sure that if you know, if you have senior loved ones and you’re you know, or if you’re over the age of sixty five, these are things that you need to take care of Pronto. I mean, and this is the kind of time of year we’re coming up on the holidays, you may be seeing your senior loved ones, things like that on. These are important questions to ask mom and Dad. Aren’t they absolutely the caretaker, as we like to call those folks? Yeah, which doesn’t mean that it’s a paid care take. No, a caretaker could be a spouse, that could be a child, that could be anyone that helps. That closed to sixty million in the United States are caring for senior loved ones right. Yes, and and I feel I’m one. I used to take care of my mom and you know, the interesting thing is is that, as an advocate and already being in a position where I sit on a brokerage side, I become more of an advocate and ask questions, you know, like are we seeing the right doctor for you? Are You satisfied with your plan? Are you getting what you need out of this plan as your healthcare changes, as your health change? So you know, you have the annual enrollment period it which is the fifteen of October to December seven. But if you’re tied up and you made a decision and it was too hasty, you have an opportunity come the open enrollment period to make an effective change that will help your health. That’s important, absolutely. And so we are talking again to Dan reddler and Dan Leary, from we speak Medicare, and you guys handle the entire state of Washington and you know, what you basically do is help guide people to the right plan for them individually, and I think we’ve talked a little bit about you know, what does that mean specifically? It means really tailoring a program for an individual and and I’m using that word really really emphasizing, because it doesn’t mean that mom or dad should be on the same plan necessarily. Sometimes it’s better that they’re not on the same plan. Is that correct? It is right. Everybody has different needs and it you know, there’s a financial argument to be made for paying less if you’re not using the serif it and then the the other end of the spectrum is you can pay a really high premium and everything will be covered. Right, but what’s best for you? Right, right. So how do we reach to just so you know, and we want to make sure that our listeners have a good number to reach you guys. You can reach us at eight hundred and seven, seven, three, four, six, two zero, six, zero or www dot speak medicure dot org. That is important. So, now that we’re into the holidays, on Dan, I really want to thank you for some of the questions that you’re asking. If you have seen your loved ones, what are the kind of questions they should be asking Mama Dad? Well, one of the questions they should ask them it’s pretty simple. Have your prescriptions changed recently? Great Question. Are you having trouble paying for your prescriptions? Great questions. Right. So these are all things that if they hear something that is changed, are they’re having difficulty paying, they need to pick up that phone and call us right away. Yeah, because there could be a such special needs plan available for that individual. Absolutely. So I think it’s really important, as we talked to the caretakers and then we talked to the listeners on this show, don’t be afraid to ask your loved one if their healthcare is is actually hurting them, meaning, are you paying too much for your healthcare? Are you able to afford your prescription drugs. Is your health plan really working for you and are you able to afford it? Good questions all, because if not, it’s really horrible knowing that in this market place of Washington, where there are numerous zero premium plans and many would zero out of pocket costs, that’s someone like that would be put on a plan where they would have to pay a premium or have out of pobsolutely when they’re going to make a choice between splitting pills or eating food. Yeah, so it’s not story. Shout like that all too ill to and we do too off throughout the whole state. It’s and it’s embarrassed and it’s and it’s sad to you know, it upsets me to know in that our seniors get treated this way. But I think there’s others, you know, resources available, such as what you guys do, that can help families through this process, especially in you know, when you’re dealing with expensive medications and things like that, that you know they shouldn’t have to go hungry. For sure. No, and that’s you know, when I when I look at this and the premise of your program right and in answers for elders. That’s what this is about. Yeah, absolutely. This is not a one trick pony. No, because when you’re talking healthcare, you’re also talking about where they live, what they eat, their prescriptions. There’s so many pieces and maybe they don’t get to live at home anymore. I always say elder care or later life is so interconnected. Yes, it’s like one little tiny, you know, shift that happens. It’s like everything else has to change around you. So that’s a really good point. So how do we reach you, guys? So the best thing to do is is to pick up the phone and call us at one hundred and eighty seven, seven, three, four six, two, zero six, zero, Uh Huh, or reach out to us at we speak Medicare dot org. We’re here to help, where a phone call away. It’s it is our pleasure to help you and an honor, awesome and you know what, before we close, I just want to which all of you, number one, say thank you, and, number two, happy holidays to you guys, happy Hollide, wonderful holiday season. Thank you. Thank you so much. The preceding podcast was provided by we speak Medicare and answers for elders. Radio to contact, we speak Medicare, go to we speak Medicare dot who rg or call one hundred and eighty seven, seven, three four six to zero, six, zero,


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Originally published November 24, 2019

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