Medicare Open Enrollment Period Offers Options

It’s time again to shop for your best coverage on Medicare drug and health plans.

Medicare’s open enrollment period runs from November 15 until December 31.


Every year, the Medicare Open Enrollment Period gives Medicare beneficiaries a chance to evaluate their current plans and see what other options might be out there to serve their needs, especially if their health status has changed.

You can think of the Open Enrollment Period as your yearly coverage “check-up.” It is important to look closely at your plan, look at the options available, consider your health and find what works for you.

And this year it is especially important because with the passage of the Affordable Care Act there are great new benefits and options for seniors under Medicare.

Those enrolled in Original Medicare will have access to free wellness visits and free recommended preventive services like mammograms or colonoscopies.  If you fall into the prescription drug coverage donut hole, you’ll receive a 50 percent discount on your covered brand-name drugs if you are eligible while in the donut hole.

And at HHS we’re cracking down on Medicare waste, fraud and abuse.

The Affordable Care Act will make Medicare stronger and more sustainable, all with the goal of improving the care and health of seniors.

Insurers should have mailed out notices telling you of any drug or health coverage changes for 2011. Some changes include adjusting premiums, co-payments or other cost-sharing rules.

And there are plenty of great choices for 2011.  In New Jersey, 33 prescription drug plans, include premiums starting at $14.80 with the national average at $37 in 2011 a month.

But you should also remember to look beyond premiums. The only way to determine the true cost of your drug coverage is to check other factors like deductibles, co-payments and coinsurance.

As in the past, 95 percent of Medicare beneficiaries in Medicare Advantage Plans and Prescription Drug Plans can stay in the same plan they have today.  But, if you’re one of the very few people enrolled in a plan that won’t be returning next year, there are a lot of quality affordable choices available.

All Medicare Advantage beneficiaries should take a look at their options.  This year, premiums in Medicare Advantage will go down an average of one percent while providing meaningful choices for beneficiaries.

And of course, Medicare’s website — — is a great tool for helping you narrow your search for new drug or health coverage. Just click on the “Health and Drug Plans” tab to begin reviewing your options.

After entering your ZIP code and the list of your prescriptions, you can use the “Medicare Plan Finder” tool to compare your coverage options and out-of-pocket costs under different plans in your area.

And because the quality of a health plan’s customer service should also be considered, the site will help you identify the best, using the Medicare Plan Finder star ratings tool to rate each plan.

Besides using, you can call Medicare’s toll-free help line at 1-800-633-4227 or consult your “Medicare & You” handbook, a comprehensive guide to Medicare benefits mailed to the homes of all eligible beneficiaries.

One-on-one benefits counseling is also available through your State Health Insurance Assistance Program, NJ SHIP.  In New Jersey, you should call 1-800-792-8802.

If you’re having difficulty affording your medications, you may be eligible for Extra Help, which helps pay for your premiums, deductibles, and co-payments. People who receive Extra Help don’t have a coverage gap and therefore do not qualify for the 50 percent discount in 2011. .

The amount of Extra Help depends on your income and resources. But generally, if you qualify, you’ll pay no more than $2.50 for generic drugs and $6.30 for brand-name drugs.

Thirty-five percent of New Jersey’s Medicare beneficiaries with Part D drug coverage now get such a break.

To learn more about whether you qualify for the program, visit or call Social Security at 1-800-772-1213.

Though the enrollment period runs until the end of the year, it’s smart to make any coverage changes by early December to ensure a smooth transition to your new coverage on January 1.

Even if you’re satisfied with your coverage, it never hurts to review your Medicare plan.  You could save money, improve your coverage, or both.

So take some time today to review your coverage and start shopping.

Dr. Jaime Torres
Region II Director
U.S. Department of Health and Human Services

Connect with NJTODAY.NET

Join NJTODAY.NET's free Email List to receive occasional updates delivered right to your email address!
Email for advertising information Send stuff to NJTODAY.NET Like Us On Facebook Follow Us On Twitter Download this week's issue of NJTODAY.NET
Print Friendly, PDF & Email