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otherOctober 3, 2016

Anyone 65 or older who is enrolled in Medicare Part C or D soon will have some important decisions to make. Open enrollment for the plans runs from Oct. 15 to Dec. 7 and coverage for next year begins Jan. 1. Jackie Dover, public information director for Aging Matters in Cape Girardeau, says it's vitally important for enrollees to check on their existing plans before any increases take them by surprise. ...

Cutline-File Credit:Stock photo
Cutline-File Credit:Stock photo

Anyone 65 or older who is enrolled in Medicare Part C or D soon will have some important decisions to make.

Open enrollment for the plans runs from Oct. 15 to Dec. 7 and coverage for next year begins Jan. 1.

Jackie Dover, public information director for Aging Matters in Cape Girardeau, says it's vitally important for enrollees to check on their existing plans before any increases take them by surprise. Or, if their health needs have changed since the last enrollment period, to make sure their coverage includes new medications or services.

"For seniors, the most important thing is the cost of the plan," she says. "That's not just the premium, but the deductible and co-pay on the medicine."

Medicare's Part C consists of Medicare Advantage plans, which generally combine health-care services with prescription drug benefits using a single ID card.

Cutline-File Credit:Stock photo
Cutline-File Credit:Stock photo

These plans usually are administered by managed health organizations such as HMOs and PPOs, Dover says.

With Part D, only prescriptions are covered.

Most of the time, area senior citizens will have received an annual notice of change in their plans by late September or early October.

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This helps them pinpoint what items that used to be covered won't be covered any longer, or which deductibles are going to rise.

On Oct. 1, the Centers for Medicare and Medicaid Services also should have released data on plan changes for 2017.

Sometimes, plans can go from having no deductible or a lower deductible to the maximum amount, which soon will be changing to $400, Dover says.

Monica Motes, an insurance agent at Marathon Benefits Group in Cape Girardeau who specializes in Medicare plans, says plan formularies change from year to year, so understanding those changes is crucial as soon as the information is available.

Not only can costs change, but so can coverage and what health-care providers and pharmacies are considered in-network.

"It's in (people's) interest to always evaluate it," she says.

For anyone getting ready to age into the Medicare system, Motes says they should begin doing their research about Medicare coverage three months beforehand, and sometimes as early as six months.

If a person decides to retire after age 65, he or she has 63 days to opt into a plan.

For those who need help wading through all the different Medicare options, Dover says Aging Matters (formerly the Southeast Missouri Area Agency on Aging) holds boot camp events periodically, but also invites anyone with questions to make an appointment for free advice by calling (573) 335-3331.

Other resources include cms.gov or 1-800-MEDICARE, along with making an appointment to explore options at the local State Health Insurance Assistance Program Office, which can be found by calling (800) 633-4227.

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