(Good Things Utah) Medicare Annual Enrollment is a once-a-year opportunity for millions of Americans to pick a health plan or make changes to their current healthcare coverage. It’s important to know your Medicare Annual Enrollment dates.

Medicare Annual Enrollment isn’t the same or at the same time for everyone, so there are key dates to keep in mind depending on your situation:

  • Many employers set aside a two-week period between September and December when employees can select health benefits for the following year.
  • Medicare Annual Enrollment or AEP (annual election period) runs from Oct. 15 to Dec. 7 each year.
  • Health insurance marketplace or individual state exchange open enrollment runs from Nov. 1 to Dec. 15, in most states.

Each person or family has unique health and budget needs.  There is no one-size-fits-all approach to selecting a health plan.

For most people, if they don’t make an enrollment decision, they’ll be locked into their current plan for an entire year. If anything has changed this year, either with their current plan, health status, or budget, the decision to do nothing could lead to an unpleasant surprise or missed cost savings.

What are the best ways to make smart decisions during Medicare Annual Enrollment?

A great place to start is with your doctor. If you are happy with your current provider, confirm that they will be in the care provider network for the health plan you choose. You shouldn’t assume that your provider will stay in the same network every year.

Three key steps to choosing the best care include:

  • Knowing your needs: determine what’s important to you and if you are getting what you need with your current doctor and health plan. For example, does your doctor specialize in serving adults 65+ on Medicare Advantage plans? Do they make time for you or make you feel rushed? Are you given a personalized care plan that helps you meet your individual health goals? All of these are important determinants to ensure you get the health care you deserve.
  • Explore your choices: Do you need coverage that provides dental, vision, and hearing? If you are Medicare-eligible, Original Medicare does not cover these. But a Medicare Advantage plan may. Find out what’s important to you and review your choices.
  • Choose your option: Once you have reviewed your choices and determined what your individual needs are, it’s time to make a choice. Call 1-866-964-1547, TTY 711, Monday through Friday, 8 a.m. to 5 p.m.
    • California residents, call 1-877-267-8861, Monday through Friday, 7:30 a.m. to 6:30 p.m.
    • If you are a Medicare beneficiary, you can visit the Center for Medicaid & Medicare Services (CMS) website at www.medicare.gov, call 1-800-MEDICARE, 24 hours, seven days a week or contact Medicare Advantage plans directly.

Another good resource is an independent licensed insurance agent or health plan sales agent. These professionals help people learn about their benefit options, what’s going to fit their needs, and how they can continue seeing the doctor(s) they prefer. They can be especially helpful for older adults and/or Medicare beneficiaries who may need health plans that specialize in chronic conditions or cover alternative medicine.

Agents typically get paid a commission to sell you a policy, although they offer coverage from several health plans.



What happens if I avoid participating this year?

If you miss Medicare AEP, you will likely miss your window to make changes to your healthcare coverage for the following year. There may be special circumstances, so be sure to visit the Center for Medicaid & Medicare Services (CMS) website at www.medicare.gov, to find out more.

For most people, if they don’t make an enrollment decision, they’ll be locked into their current plan for an entire year. If anything has changed this year, either with their current plan, health status, or budget, the decision to do nothing could lead to an unpleasant surprise or missed cost savings next year.

What are key aspects to consider when looking at coverage options?

When shopping for coverage, people should consider three important points: Choice, Care and Experience.

  • Choice: When it comes to selecting a plan, one size does not fit all. Take the time to explore your options and make sure you understand the costs and benefits of each plan so you can find coverage that works best for you.
  • Care: In addition to providing access to doctors and hospitals, you should search for a plan that offers benefits that are important to you.
  • Experience: It’s important to find a plan that offers benefits that will make the most sense for you. For example, you may need to find a plan that will include telehealth options or additional behavioral health services.

Some additional questions that may be important to discuss with your health care provider are:

  • How often do you visit the doctor?
  • What prescription medications do you normally take?
  • Do you have a particular doctor, hospital or pharmacy that you want to use?
  • Do you have retirement health coverage?
  • Would you rather pay less in monthly premiums or pay less out of pocket when you receive health care?

Also, check if your plan includes 24/7 telehealth services for consultations on minor health issues. Often, telehealth – defined as online, or virtual, visits with a doctor over a computer, tablet, or mobile phone – is available to people enrolled in employer-sponsored health plans and group Medicare Advantage plans, as well as select individual Medicare Advantage plans.

For more information, go online to Optum.com/Utah.

Questions? Call 801-982-3885.



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