Medicare open enrollment: What you need to know

Medicare open enrollment: What you need to know

By Mike Festa

For those with Medicare, October marks the beginning of the yearly Medicare open enrollment period, which officially begins on Oct. 15 and runs through Dec. 7. This is the one chance the nearly one million Medicare beneficiaries in Massachusetts have to review and make changes to their coverage for the year ahead. During open enrollment, you should compare expenses, including premiums, deductibles, drug costs and out-of-pocket maximums.

During open enrollment, you may:

•Switch to a Medicare Advantage plan;

•Switch from one Medicare Advantage plan to another;

•Drop your Medicare Advantage plan and return to Original Medicare; or

•Join a Medicare Prescription Drug plan, change to a new one, or drop your coverage.

Mike Festa_050614Even if you are satisfied with your current coverage, it’s always a good idea to review your plan, see what new benefits Medicare has to offer, and ensure that your Medicare plan works for you in the coming year. To help you decide which Medicare plan works best for you, visit the official Medicare website at Online tools help you find and compare all available plans in your area. When reviewing plans, focus on the benefits, such as which prescription drugs are covered.

If you need help comparing coverage options, call your local senior center or Council on Aging to make an appointment with a SHINE (Serving the Health Information Needs of Everyone) counselor. The SHINE program is a state health insurance assistance program that provides free health insurance information, counseling and assistance to Massachusetts residents with Medicare and their caregivers. The SHINE program, administered by the Massachusetts Executive Office of Elder Affairs, works in partnership with elder service agencies, social service and community based agencies, and Councils on Aging. The program is partially funded by the federal agency Centers for Medicare & Medicaid Services.

When it comes to doctor’s appointments and filling prescriptions, convenience matters. When reviewing Medicare plans, find out if you will have access to your current doctor — or doctors close by. And, check that your local pharmacy accepts the plan, and that the plan provides online prescription-filling or mail order options.

Quality and performance varies across plans. Medicare’s star-rating system comparatively measures health plans on quality and responsiveness of care; success in managing chronic conditions; allowable preventative screenings, tests and vaccines; the number and nature of member complaints and appeals; and customer service. Medicare’s rating system also assesses prescription drug plans on quality, pricing, customer service and member satisfaction.

Once you compare coverage, cost, convenience and customer service, you will be ready to make a well-researched decision to either change your plan or stay with the one you have.

Remember, it’s important to review your options carefully. In some cases, if you drop your coverage, you may not be able to get it back. Also, during this sole season of Medicare open enrollment, if you miss the Dec. 7 deadline, you will have to wait until October 2015 to switch to a different Medicare plan.

For quick answers to some of the most common questions, visit AARP’s Medicare Q&A tool at or call 866-448-3621 and request a free copy of booklet #D20046 Meet Medicare.

Michael E. Festa is the state director of AARP Massachusetts, which represents more than 800,000 members age 50 and older in the Bay State.  Connect with AARP Massachusetts online at; Like us at and follow us on

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