The Medicare Annual Enrollment Period (AEP) is right around the corner! This is an important time to start thinking about your current Medicare coverage and what your healthcare needs will be starting January 1st. If you currently have a Medicare Advantage or Medicare Prescription Drug Plan, your plan will send you an “Annual Notice of Change” (ANOC) prior to September 30th. The ANOC provides valuable details about any changes to your plan’s coverage, costs, or service areas that will take effect January 1st of the upcoming calendar year.
In the ANOC your plan sends, there are a few key parts that you should pay close attention to:
Provider Network Changes:
Is there a specific doctor you want to continue seeing, hospital you prefer, or even pharmacy you want to use? Provider network might be a deciding factor when choosing to keep your current plan or change to a new one.
- Many Medicare Advantage plans will not cover services provided by an out of network doctor or at an out of network facility, so you will be responsible for the full cost yourself. When you receive the ANOC for your plan, look out for provider network changes to make sure your doctor is still covered.
- Medicare Advantage and Prescription Drug plans can also have a network of pharmacies they use. Some have “preferred” and “standard” pharmacies, which you decide to fill your prescription at can affect the cost you pay. These networks can also determine which mail order pharmacy you use. Pay close attention if a specific pharmacy is important to you!
Prescription Drug Coverage Changes:
Changes to your plan’s drug formulary, the list of drugs that are covered, is important! It can affect not only what drugs are or aren’t covered, but also the costs for those drugs.
- A specific drug can be completely removed from a plan’s drug formulary and your plan will no longer cover costs for it, or the drug tier can change resulting in your cost share being more or potentially less. Your plan’s ANOC will let you know if there are changes to the plan’s prescription drug coverage.
You’re probably quite familiar with your plan premium. It will likely standout on the ANOC if the premium’s changing January 1st. There are other costs you may not notice as easily that are important to look for.
- When you go to the doctor or get medical treatment, you don’t want to be surprised by a bill that is higher than what you’re used to. When you receive the ANOC for your plan, look for any changes in your plan’s deductibles, copays/coinsurance, and the plan’s maximum out of pocket amount.
- In addition to the cost to fill each of your individual prescriptions, consider the total out-of-pocket spending for drugs. If you take multiple prescriptions or specialty drugs, cost changes with your prescriptions can affect if/when you hit the Medicare Part D coverage gap. The coverage gap is commonly referred to as the “donut hole”. Learn more about the donut hole in our blog.
The Annual Notice of Change (ANOC) sent by your Medicare Advantage or Prescription Drug Plan is a valuable resource to guide your decision-making. Still, it can be a lot to try and review your current plan and any changes taking effect next year. Trying to figure out if there are different plan options that works better for you on top of that can add on even more stress! Our friendly, licensed agents can help you consider all the key factors so you can make an informed plan choice to best meet your healthcare needs. Contact us here