Seniors Take Notice! It’s Time to Review Your Medicare Health Insurance and Prescription Plans

October 1, 2013
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For senior citizens, the most important decision you will make this Fall comes in the form of keeping or choosing the most appropriate Medicare coverage options for next year. In most cases, this may be the one chance you have to make a change to your health and prescription drug coverage for 2014.

The open enrollment period runs from Oct. 15 through Dec.7. This is an important opportunity for people on Medicare to review and choose what coverage they want for 2014. Every year Medicare drug plans and Medicare Advantage plans can change their premiums, deductibles, co-payments, benefits and the drugs they cover. You could be surprised on January 1st if you stay with your current plan and find it doesn’t provide the coverage you want or need. Trying to pick the best Medicare prescription drug plan for an individual beneficiary can be an overwhelming task, since there are so many plans to choose from and there are various factors that must be considered. Fortunately, CMS (the Center for Medicare and Medicaid Services) has developed a very helpful online “planfinder” tool which you can access at This tool will allow you to search for plans in your area as well as investigate which medications are covered under each plan’s formulary.

If you choose to change your health insurance coverage during open enrollment season, a basic choice is whether to enroll in a Medicare Advantage (MA) plan or a traditional Medicare plan. In either case, you’ll need to pay a monthly premium for Part B coverage, which for most retirees is $104.90 in 2013. MA plans or Medigap policies cover some medical costs not covered by Medicare. MA plans provide basic medical services covered by Medicare, plus some costs that would normally be paid out-of-pocket if you didn’t have any supplemental coverage. MA plans generally require you to use health care facilities, doctors and other professionals in the MA plan’s existing network, although some plans may cover out-of-network expenses. The total premiums paid for Medicare and MA plans combined are often lower than the total premiums combined of the traditional Medicare plan and supplemental Medigap plans. One basic tradeoffs however is the freedom of choice you have regarding doctors and facilities that are available under traditional Medicare plus Medigap insurance. In addition, if you enroll in traditional Medicare, you’ll need to buy Part D coverage (coverage for prescription drug costs) separately. Most MA plans cover the cost of prescription drugs, although some may require that you buy Part D coverage separately.

If you find this task daunting there are places you can turn for help. New York State offers the Health Insurance Information and Counseling Program (HIICAP). To contact a HIICAP counselor in your area, call 1-800-701-0501 or visit their website at

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