Now is the time for Texans with Medicare to look over their health and drug coverage for 2018.
For most Texans, Medicare’s annual open enrollment period runs from Oct. 15 until Dec. 7. Individuals affected by Hurricane Harvey, however, may contact Medicare at 1-800-633-4227 and request a special enrollment period lasting until Dec. 31.
Even if you’ve been satisfied with your health and drug plans, you may benefit from reviewing all your options. Some plans have adjusted their out-of-pocket costs and benefit packages for next year. Shopping around may save you money or improve your coverage.
Here are four things to know as you sort through the Medicare health and drug plans available for 2018.
1) Generally, health and drug plan premiums will be stable next year.
Texans in Medicare’s original fee-for-service program can choose from 24 drug plans with monthly premiums ranging from $16.70 to $197.10 – about the same premium range as last year. Nationally, the average premium for a basic drug plan will drop $1.20 to $33.50 per month.
Texans who prefer an alternative to the traditional Medicare program may join a Medicare Advantage health plan sold by a private insurer. Most plans include drug coverage. Thirty-three percent of Texans with Medicare now opt to get their health care benefits this way.
Many Advantage plans charge a separate premium on top of the Part B premium you’ll pay for Medicare’s medical insurance. Nationally, the average monthly cost for that separate Medicare Advantage premium will be $30 in 2018 -- $1.91 less than this year.
Look beyond premiums, though. The only way to determine the true cost of your coverage is to consider other factors like deductibles, co-payments and coinsurance. Medicare’s website – www.medicare.gov/find-a-plan – has the best tool for helping you narrow your search for a new health or drug plan.
2) Check the quality of a health or drug plan’s service, too.
To help you identify the best and worst Medicare plans in your area, www.medicare.gov/find-a-plan provides star ratings for each. The ratings range from five stars (excellent) to one star (poor); three stars are average.
Higher-rated plans deliver a higher level of care, such as managing chronic conditions efficiently, screening for and preventing illnesses, and making sure people get much-needed prescriptions. Higher-rated plans also provide better customer service, with fewer complaints or long waits for care.
3) If you need help comparing health or drug plans, it’s readily available.
There are four places to turn for assistance:
-- Visit www.medicare.gov/find-a-plan to compare your current coverage with new health or drug plans. If you want to make a change, the website will guide you to where to enroll in a new plan.
-- Call Medicare’s help line at 1-800-633-4227 at any hour and talk with a customer service representative.
n Consult your “Medicare & You 2018” handbook, which you should have received in the mail in the last few weeks. The book may also be viewed at www.medicare.gov.
-- Get one-on-one benefits counseling through Texas’ State Health Insurance Assistance Program. You may call 1-800-252-9240 for the counselors nearest you.
4) If you’re on a tight budget, see whether you can get help paying for your prescriptions.
If you’re having difficulty affording medications, you may qualify for the government’s “extra help” program. The amount of help depends on your income and resources. Generally, you’ll pay no more than $3.35 for each generic drug and $8.35 for each brand-name drug in 2018.
To qualify at present, your annual income can’t be more than $18,330 if you’re single or $24,600 if you’re married. Also, your resources can’t exceed $13,820 if you’re single or $27,600 if you’re married. Savings and investments count as resources, but homes, cars and personal belongings do not.
Thirty-two percent of Texans with a Medicare drug plan get extra help. To apply, visit the Social Security website, at www.socialsecurity.gov/i1020, or call Social Security at 1-800-772-1213.
There’s no better time to check your Medicare coverage. Any changes you make will take effect on Jan. 1.
Bob Moos is Southwest public affairs officer for the U.S. Centers for Medicare and Medicaid Services