If you’re a Medicare Advantage beneficiary, there’s something coming soon to your mailbox – either by email or snail mail. It’s the Annual Notice of Change that your insurer sends you by September 30th each year. The purpose is so you can see how your plan will be changing in the year ahead, and in that way make a better, more informed decision when open enrollment begins.
Whatever you do, say the experts, don’t simply toss your Annual Notice of Change, or hit “Delete.” We’ve seen statistics that suggest that’s more or less what 70 percent of beneficiaries do: they ignore open enrollment entirely. But, as this recent Kiplinger article explains, if you have Medicare Part D or a Medicare Advantage plan, “reviewing your Annual Notice of Change is crucial. It can save you money and ensure you can still see your preferred doctors and hospitals.”
Reporter Donna LeValley wrote the Kiplinger article to remind us – well ahead of this fall’s open enrollment period beginning October 15th – that this notice contains essential information that can alert you rising premiums, reduced benefits, or restricted network coverage. These changes, left unaddressed, can wreak havoc with your health! Let’s take a look.
Don’t Leave Your Vital Health Insurance on Autopilot
If you haven’t already received your Annual Notice of Change (ANOC) letter from Medicare, you very likely will soon. And LeValley cautions: don’t toss it!
“If you have a Medicare Part D or Medicare Advantage Plan, this document is crucial,” she writes. “The information inside will help you decide whether to keep your current coverage or find a new plan for the coming year. Don’t make the mistake of keeping your plan on autopilot without reviewing it first.”
This document, she explains, is a required piece of information that Medicare Advantage (MA) and Medicare Part D prescription drug plans send to their members every fall. It provides a detailed summary of the benefits, costs, and coverage in your plan for the upcoming calendar year.
LeValley writes, “The arrival of the new notice is an opportunity to consider whether your current Part D drug plan or MA plan is still the best way to receive the care you need at a price you can afford. If not, it may be time to change plans.”
She adds that if you don’t see your ANOC letter by September 30, you should feel free to contact your plan provider to request one either by mail or email (your choice).
The Annual Notice of Change Contains Critical Information
Why is the ANOC so important? It compares your current plan’s benefits with what’s on offer for the upcoming year and highlights any changes you should be aware of. Some key information you’ll find in the ANOC (along with related questions LeValley advises asking as you look over the letter) includes:
Cost Changes: Any updates to your monthly premium, annual deductible, copayment, and coinsurance for doctor visits, hospital stays, and other services.
Suggested Questions: For Medicare Advantage plan participants, has your maximum out-of-pocket limit increased? Has the monthly premium changed for your MA or Part D drug plan?
Part D prescription drug plan changes: The letter will let you know if there are any changes to the plan’s formulary (the list of covered drugs). LeValley says that it’s vital to check if your current medications are still covered, or if they have been moved to a different cost tier. This could significantly change your out-of-pocket costs.
Suggested Questions: Are there any coverage restrictions for your medications, such as quantity limits or prior authorizations? How much will you pay for generic and brand-name drugs? Is your pharmacy in the plan’s network? Is it a ‘preferred pharmacy’ that offers the plan’s best pricing?
Provider network updates: This section will let you know about any changes to the plan’s network of participating doctors, hospitals, and pharmacies.
Suggested Questions: Are your current doctors in the network? Are hospitals or specialists you may need in the network? Are you willing to switch to other providers if your preferred choices are not in the network anymore?
Coverage/Perk changes: The ANOC letter will detail any new benefits that have been added to your MA plan, along with existing benefits that have been removed or modified. These can often include coverage for dental, hearing, or vision benefits.
Suggested Questions: Will you need a referral from your primary care provider to see a specialist? What new benefits have been added to your plan? What existing benefits have been eliminated from your plan?
Essential Tool to Help You Make the Right Health Care Decision
Information is power, as the saying goes. The ANOC letter is full of critical information that you’ll need to make sure that your healthcare coverage is sufficient to your needs during the Medicare Annual Enrollment Period (AEP), which runs from October 15 to December 7 annually.
The ANOC can help you in three key ways. First, it prevents unpleasant surprises. “Without reading the ANOC, you could be surprised on January 1 by higher costs, a medication no longer being covered, or that your doctor or preferred facility is no longer in your network,” LeValley writes. You may also find benefits being eliminated or reduced as insurers seek to cut costs.
Second, it provides you with actionable information. If you’re not happy with the upcoming changes, the arrival of the letter is a perfect reminder to explore other plan options available in your area. “You can then switch to a new Medicare Advantage or Part D plan during the AEP that better suits your needs,” LeValley adds. “You can even switch back to original Medicare from an MA plan.”
And finally, the ANOC empowers you. It puts the control in your hand to make the right decisions for your health and your finances. “Even if you were happy with your plan this year, the changes outlined in the ANOC might make it less suitable for you next year,” LeValley writes.
Make a Wise Choice by Getting the Right Advice
“Take time to review your plan,” LeValley urges. “You don’t want to be caught off guard by higher costs or coverage changes after January 1. Whether you decide to stay with your current plan or to explore other Medicare coverage options, you want to make that choice based on the facts.”
Have questions about the changes? Contact your plan’s customer service department, LeValley says. They can help explain the details to you.
LeValley goes on to list some helpful Medicare-based resources for any further questions. We’ve included them here verbatim:
If you want to look at Medicare Advantage and Part D plans in your area, you can use the Medicare.gov/plan-compare tool to compare health and drug plans in your locale.
1-800-MEDICARE: You can call this number to ask questions about your Medicare options. Help is available 24 hours a day, except on federal holidays, when the offices are closed. TTY users should call 1-877-486-2048. Or, visit Medicare.gov.
State Health Insurance Assistance Programs (SHIPs): Contact your local SHIP for free, personalized counseling from trained volunteers. Federally funded SHIPs provide unbiased help (to people and their families) with Medicare issues and finding coverage.
(Note that in Washington State, home to AgingOptions and Life Point Law, the program is called Statewide Health Insurance Benefits Advisors (SHIBA) and is part of the Office of the Insurance Commissioner.)
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(originally reported at www.kiplinger.com)