Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
As clinicians, we work with Medicare beneficiaries in nearly all post-acute communities – nursing homes, assisted living, outpatient clinics and home health, to name a few. We’re often asked questions about Medicare. We may also have questions about Medicare. I’m blogging today to provide some basic information and resources to share with folks looking for more information. It’s also useful if you’re looking for more information for yourself or loved ones.
Every year in the fall, there is an Open Enrollment period for existing Medicare beneficiaries. This year’s Open Enrollment period is Thursday, October 15th through Monday, December 7th. During this time, you can switch or drop your plan coverage.
You can find introductory information as well as links to other resources at Medicare Enrollment Period – 2020. You can view a 3-minute video entitled Understanding Medicare Enrollment Periods. There’s also helpful information on what to do if you missed your initial enrollment (that starts 3 months before you turn 65 and ends 3 months after you turn 65).
Beneficiaries have a lot of things to consider during Open Enrollment –
- Staying with or returning to original/traditional Medicare
- Staying with or returning to Medicare Advantage plan (an alternative to the original/traditional Medicare) … this is also known as Medicare Part C
- Staying with or switching to a different Medicare Part D plan (drug coverage)
If you’re looking for information about Medicare Advantage plans, here are some very helpful links to explore:
Another helpful resource is Medicare and You – 2021. This is the 2021 version of the annual U.S. government Medicare handbook. Here’s what you’ll find in this 124-page handbook:
The handbook covers a lot of material. You can download it and save electronically for future reference. You can also get a paper handbook by calling 1-800-MEDICARE (1-800-633-4227). The handbook is also available in different formats – large print PDF, eBook (e-readers), audio and braille.
The Medicare beneficiaries you work with can utilize their pharmacy for assistance in reviewing/comparing Part D drug coverage plans. Additionally, there is good news for Medicare beneficiaries who use insulin beginning January 1, 2021:
The Part D Senior Savings Model allows Medicare patients who use insulin to choose a prescription drug plan that covers multiple types of insulin for $35 or less each for a month’s supply. Starting October 1, patients can visit Medicare.gov/plan-compare and filter on “Insulin Savings” to find plans that cap out-of-pocket costs. Patients should check plans to:
- Make sure their type and brand of insulin is covered
- Find out about the deductible, initial coverage, and coverage gap periods that should be no more than $35 for a month’s supply of different insulin types
Patients can enroll in a participating plan from October 15 to December 7, with coverage starting on January 1, 2021. Patients who enroll in a plan participating in the model can save an average of $446 in annual out-of-pocket costs, or over 66 percent, compared to their average cost sharing today. This more predictable copay for your patients will improve access and help you manage their care.
For more information on this program, check out these resources:
One last word – encourage all of the Medicare beneficiaries you work with and care for to get a flu shot this year!! Don’t forget to get your flu shot – also your family, friends and colleagues.