First State Times

As the October 15 to December 7 Medicare Open Enrollment quickly approaches, the Delaware Department of Insurance and its Medicare Assistance Bureau (DMAB) are sharing their annual consumer information announcement.

During Medicare Open Enrollment, consumers can join, switch, or drop a Medicare Prescription Drug Plan (Part D) or Medicare Advantage Plan. DMAB’s free, confidential, unbiased one-on-one assistance can help residents determine if making a coverage change is the right choice. In 2021, DMAB provided more than 5,500 counseling sessions, saving beneficiaries a combined $521,000.

The department does not manage benefits offered to state employees, pensioners, or spouses. While DMAB can counsel Medicare-eligible state plan members, questions about the state’s Medicare Advantage plan or transition should first contact the Office of Pensions at 1 (800) 722-7300 and explore their online guide. Medicare Advantage plans themselves are regulated at the federal level, though the Insurance Commissioner and his peers are advocating for increased state regulatory authority.

“Our Medicare Assistance Bureau is an important resource for residents. Many Delawareans face confusion when it comes to Medicare Advantage plans, and as Open Enrollment approaches, they will begin to see an influx of television commercials and be targeted by a lot of other enrollment marketing,” said Insurance Commissioner Trinidad Navarro.

DMAB Director Lakia Turner agreed. “Many beneficiaries enroll in plans based on marketing, without fully assessing the plan’s total costs or asking key questions about their coverage, and ultimately that means they then experience unexpected issues. We work hard to inform consumers on the front-end to help ensure they get the right plan from the start.” Commissioner Navarro and Director Turner recently shared enrollment advice on Delmarva Life.

Ten Tips for a Successful Medicare Open Enrollment

1. Know that enrolling in a Medicare Advantage plan means it becomes your primary coverage. Original Medicare will no longer pay for services. You will receive a new ID card from the new plan, and should store your Original Medicare card in a safe place.
2. When moving from Original Medicare to a Medicare Advantage plan, be prepared to pay both a monthly Medicare Advantage premium and a monthly Medicare Part B premium.
3. Medicare Advantage plans do not automatically give you “more money in your Social Security check every month.” To qualify, you must be eligible for the Medicare Savings Program by having an income below Medicaid limits.
4. Check that additional benefits, like dental, vision, hearing, fitness, or over-the-counter medications are actually accessible if offered. Some network providers of these services may be farther away than anticipated, including in neighboring states, so only factor them into your decision if you feel they are usable.
5. Know that premium costs aren’t the only out-of-pocket costs you may face. Medicare Advantage plans may have co-pays or cost-sharing that differ from Original Medicare.
6. Call your preferred healthcare providers and facilities to understand if your prospective plan contracts with them. You may experience additional out-of-pocket expenses, service denial, or referral requirements if providers are considered out of network.
7. Check if a prospective plan is a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO). HMO plans require healthcare to be completed by a provider contracted with the plan’s network, otherwise the consumer will need a referral. PPO plans have both in-network and out of network providers and facilities, with consumer costs differing based on the network. HMO and PPO plans are not Medicare Supplement Plans, and may have out-of-pocket costs each visit.
8. Check if the plan provides Prescription Drug (Part D) coverage that meets your needs.
9. Be aware that in many cases, enrollment locks a person into a plan for the full upcoming calendar year.
10. Scrutinize any contact carefully during Medicare Open Enrollment to ensure it is from a known, credible source. Commercials, cold calls, and other contact may be scams or can provide deliberately misleading information about a plan.

About the Delaware Medicare Assistance Bureau

The Delaware Medicare Assistance Bureau provides free one-on-one health insurance counseling for people eligible for Medicare. Residents can call DMAB at 1 (800) 336-9500 or (302) 674-7364 to set up a free, confidential session or visit the DMAB website for important educational resources. Counselors can assist with Medicare, Medicare Advantage, Medigap (Medicare Supplement Insurance), long term care insurance, billing issues, prescription savings, and much more. DMAB has a Virtual Welcome to Medicare Seminar helpful for new and soon-to-be Medicare beneficiaries and those exploring enrollment changes.

Be aware of non-compliant alternative health plans

Original source can be found here.