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Medicare Open Enrollment - Benefits for Patients with Diabetes

Medicare Open Enrollment takes place from October 15th, 2017 through December 7th, 2017. This yearly event gives Medicare beneficiaries opportunities to enroll in new Medicare plans or make changes to their existing plans based on their care needs.



July 19, 2017

Are You Ready for Medicare Open Enrollment This Fall?

Making sense of Medicare isn’t easy, but in this post, we’re unpacking all the important bits so that you can be sure you’re getting the coverage you need and that you’re ready for open enrollment coming up October 15th.

What is Medicare?

Let’s start with the basics: Medicare is the government-run health-insurance plan for people age 65 and older, people under age 65 with disabilities, and people with End-Stage Renal Disease (ESRD).

Medicare consists of four main parts that read like a can of Alphagetti.

Medicare Part A (Hospital Insurance)

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B (Medical Insurance) 

Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Together, Part A & Part B are often referred to as “Original Medicare.”

Medicare Part C (Medicare Advantage Plans)

This is a type of Medicare health plan offered by a third-party private company that, in cooperation with Medicare, can provide you with all the benefits of Part A and Part B. Many Medicare Advantage Plans also offer prescription drug coverage.

Medicare Part D (Prescription Drug Coverage)

Part D plans cover the cost of prescription drugs for which Original Medicare alone doesn't pay and is offered through private Medicare-approved insurance companies.

How do I sign up for Medicare?

For a step-by-step guide to signing up for the Original Medicare (Parts A & B), visit medicare.gov. For Parts C & D, there’s open enrollment. And that’s where we’re going to focus today.

What is open enrollment?

Open enrollment is a period of time when individuals have the opportunity to enroll you can then switch to, drop, add, or amend Parts C & D of your coverage. 

When is open enrollment?

Open enrollment takes place from October 15th through December 7th every year (shortened from the original 3 months down to 45 days). 

Though enrollment takes place from mid-October to the start of December, any changes take effect at the start of the new year. For example, this year, open enrollment takes place October 15th through December 7th, 2017 but the effective date of any new plans or changes is January 1, 2018.

Why should I consider re-evaluating my current Medicare coverage during open enrollment?

If you’re happy with your current Medicare coverage (specifically your coverage through Parts C and D) you might choose to sit tight. But beware, a lack of action might end up costing you down the road.

Each year, insurance companies can make changes to Medicare plans that can impact how much you’ll end up paying “out-of-pocket” throughout the year – things like monthly premiums, deductibles, drug costs, and provider or pharmacy “networks” (the list of doctors, hospitals, or pharmacies that you can access with your plan). A recent study found that average premiums for drug plans are expected to rise by 6% this year, with some plans raising costs by more than 20%. And research from PlanPrescriber.com found that individuals can save, on average, more than $654 per year by simply by changing to a different prescription-drug plan.

Given the possible changes in your plan and in your individual situation, it makes sense to take some time each year to re-evaluate and make sure your health insurance is giving you the most bang for your buck.

There are a number of online tools designed to help you sort through the overwhelming choice of Medicare plans. The Plan Finder tool at Medicare.gov is a great place to start. There are also counselors available, free of charge, to help you find the right plan for you. "I would suggest people contact their State Health Insurance Assistance Programs for free, unbiased help," says David Lipschutz, an attorney with the Center for Medicare Advocacy, in Washington, D.C.

What are the diabetes-related benefits offered through Medicare?

If you’re 65 or older and living with diabetes then you’re going to want to pay particular attention to this part because there are a number of diabetes supplies and services that you require that might be covered by Medicare Parts B or C, including:

For prescription drug coverage, individuals must enroll in Medicare Part D and may then gain access to even more supplies like anti-diabetic drugs and supplies needed to administer insulin.

In addition, following the Affordable Care Act of 2010, beneficiaries have access to certain free preventive services related to diabetes care and management including diabetes screenings for at-risk individuals, flu shots, and Medical Nutrition Therapy (MNT).

Always be aware that there may be some out-of-pocket expenses associated with coverage. To find out how much a specific test, item, or service will cost, talk to your doctor or other health care provider. In addition, your doctor or healthcare provider may recommend you get services more often than Medicare covers, or, they may recommend services that Medicare doesn’t cover. It’s important to ask questions so you’ll understand the bottom line.

Dietitians at Home specializes in bringing diabetes-related medical equipment, treatment, and services to underserved patients and communities in the Chicagoland area. 

For more information visit dietitiansathome.com.


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