Why is Open Enrollment for Medicare and Open Enrollment for Obamacare Important?

Currently there are two open enrollment opportunities going on, Open Enrollment for Medicare: choices such as Medicare Advantage Plans, Medicare Supplements, also known as Medigap Coverage. Open Enrollment for Affordable Care Act, also known as Obamacare, this is the option for people under 65 not eligible for Medicare or Medicaid.
Open enrollment allows you to review your current plan against the plans that are available for selection the 2016 benefit year. If you are Medicare Eligible, picking the right plan allows you to not have to dig into your pocket for the 80/20 coverage. Selecting the right drug plan, can save you money. Also, if the providers (doctors) are important to you, which for most people they are, selecting the right plan can make sure the doctors you want are available for you to use. If you are eligible for Affordable Care, Obamacare, then the same rules, apply. Picking the right plan, the right providers, and at the right price, is very important for the entire year, not just for today.

The time frame for both of these Open Enrollment options are different. Medicare Open Enrollment is only available from October 15, 2015 through December 7, 2015. The time frame for Obamacare, also known as Affordable Care is from November 1, 2015 through January 31, 2016. It’s important to take advantage of these open enrollment periods to select the proper coverage for you and your loved ones, otherwise unless you have one of the RARE special enrollment options later in the year coverage is either locked in for the year at what you selected, or if you opted out of a plan then there is no option to enroll later, plus in the case of Affordable Care subject to tax implications.

What is important in a Plan?

Everyone has their own unique situation, financially, emotionally, and health wise. Plans consist of more than just the cost associated with paying for that plan, whether choosing a Medicare Open Enrollment Plan or choosing an Affordable Healthcare Plan, the amount you pay, if applicable, varies based on an individual or family size. So although cost is important, you have to be able to afford it and it has to fulfill your needs.
Plans have deductibles, co-pays, and cost of prescription drugs, referred to as the Benefit Summary. Benefit Summaries explain what each plan covers, and can be overwhelming to figure out on your own. A licensed agent does not charge to figure this out and can help narrow the confusion involved. The cost is no different than going to healthcare.gov or working with a navigator. The benefit to an individual in using an agent, is that they can help advise you based on your situation what might be the best fit for you.

Plans also normally have a network involved of doctors, providers, and hospitals. Selecting the wrong plan during Open Enrollment many people find that they have to change to a different doctor than you are use to seeing to your care or facing changes to the pharmacy that you are used to using.

Plans are available from many different insurance companies. They are all regulated by not only the state you live in, but the Healthcare Reform Act or in the case of Medicare by the Center for Medicare/Medicaid. There are many different insurance companies to choose from with each of them offering a plan different than the other and each plan from an insurance company can have an entire different network of providers (doctors, pharmacies, and hospitals).

Sometimes with all these plans, providers network, and pricing concerns figuring it out on your own can leave you overwhelmed. There is a no cost to you, free review available through your personal agent. No call center confusion by talking to us at Thomas & Associates, serving you since 1970. Let us help sort through that confusion and make sure you are in the right plan for 2016, we are can help with Medicare Choices and Affordable Care (Obamacare).