Avoiding Medicare Open Enrollment Missteps – How a Care Manager Can Help

In our last blog post, we gave some important tips to make the best choices during Medicare Open Enrollment which is taking place this year October 15 – December 7. Open enrollment is an opportunity to change how you get your Medicare coverage—Original Medicare or a Medicare Advantage Plan (also called Medicare Part C plans); switch Medicare Advantage Plans (some have drug coverage and some don’t); and join, switch or disenroll from a Medicare drug plan (also called Medicare Part D plans).

In this post we’ll show you how our Aging Life Care Professionals® (care managers) can guide their clients through the process.

Navigating enrollment

Open enrollment can be quite complicated, and depending on the person’s mental and physical health, as well as their tolerance for this type of administrative task, it can seem daunting. Beneficiaries (those who enroll in Medicare) do want to take the time to learn about their plan options and what will work best for them. For some people, this may be impossible to tackle without help.

For those who prefer to enroll on the telephone, we can sit with them and/or a responsible party (e.g., a family caregiver), and provide assistance as needed. If they have a computer and internet connection, we can either help them navigate the internet and input data, or do it while the client and/or responsible party observes.

Making the best choices

The care manager will use their knowledge of the client’s Medicare usage and medication changes from the previous year to quickly help the client find plan comparison information.

Our care managers are experienced with the enrollment process and stay up to date on changes that may affect the beneficiary. Even beneficiaries who are satisfied with their plans should take the time to review the options, as both premiums and plan benefits can change from year to year. Likewise, health conditions and medication needs can change. For example, does the client:

  • Anticipate a surgery in the coming year?
  • Have a new diagnosis – diabetes, for instance – that may change their care needs?
  • Need new medications that might be expensive?

In Medicare Advantage plans, only certain doctors and medical practices are covered—and that can change from year to year. A person who doesn’t check every year and just opts back in by doing nothing can be surprised to learn that their trusted provider is no longer covered under their plan.

We want to help prevent surprises later on in the plan year and garner whatever savings we can for the beneficiary. The care manager will discuss this information with the client and/or responsible party and help them make informed choices.

Avoiding scams

Sadly, scammers often take advantage of open enrollment time to steal personal information. Here is a current warning from the Federal Trade Commission:

Scammers might call and pretend to be Medicare representatives or agents in an attempt to steal your Medicare number or other personal information. They can use a fake CallerID name to impersonate Medicare or another organization you know. Don’t trust the name displayed on your phone’s CallerID screen. If anyone calls and asks for your Medicare, Social Security, or bank or credit card information, hang up. A scammer can use your personal information to file false claims, sign you up for a plan to which you didn’t agree, or even steal your identity.

We’ll ensure our clients are using official sites or phone number for open enrollment.

At Windward Life Care, our goal is to improve overall quality of life by helping clients to not only live comfortably, but to thrive while aging. Helping ensure clients have the best possible healthcare coverage is key to aging well. Please contact us if you’d like to hear more about us.