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Empleos

Medicare Open Enrollment Made Less Overwhelming

Frustrating is putting it lightly, right? The mail, the ads, the spam and the phone calls. Well, this page is here to bring some calm to the chaos. To walk you through the process of the Annual Enrollment Period, what you need to decide or not and how to do it well.

And know this: We’re a physician practice not an insurance company. We can’t sell you a plan or sign you up for one. We can help you sort through it all and get you thinking about what matters for your health.

What’s Happening Right Now

Each year between Oct. 15 and Dec. 7, Medicare opens a window when you can change your coverage for the coming year. Changes then take effect Jan. 1.

Your options:

  • Switch from traditional Medicare to a Medicare Advantage plan or the other way around

  • Change from one Medicare Advantage plan to another

  • Join, switch or drop a Part D prescription drug plan

  • Do nothing and stay in your current plan.(But first, make sure to check what changes in costs, drug coverage and provider networks might be occurring.)

What Happens Later

In late September you receive two things in the mail:

  • The Annual Letter of Change outlining what’s changing for next year – premiums, copays, drug coverage and providers/physician network. This letter will come from your current plan.

  • The Medicare and You booklet. Read this and the Annual Letter of Change. They are not junk mail.

  1. Oct. 1

    Details for insurance plans become public and you can start comparing plans at Medicare.gov.

  2. Oct. 15

    The enrollment period opens. You can start making changes today.

  3. Oct.-Nov.

    Best time to compare, ask questions and decide. Don’t wait for the deadline.

  4. Dec. 7

    Last day to make a change.

  5. Jan. 1

    Your new coverage begins.

  6. Jan. 1 – March 31

    If you’re in a Medicare Advantage plan and it isn’t working out; you get one chance to switch plans or return to traditional Medicare.

Your Checklist

Six things worth checking before you decide on coverage:

  1. 01

    Read your Annual Notice of Change.

    Look for changes to your premium, copays, drug coverage and your provider network. If nothing changes and your plan is working for you, staying put is a perfectly good choice.

  2. 02

    Confirm your doctors are still in-network.

    Networks change every year. Check the plan’s provider directory. Then call the doctor’s office to confirm. Directories aren’t always current.

  3. 03

    Check every prescription you take.

    Review your actual medication list, including doses. A drug that was covered this year may be on a different tier next year, or off the list entirely.

  4. 04

    Add up your real costs, not just the premium.

    A $0 premium plan isn’t free. Look at deductibles, copays and the maximum you could pay in a bad year.

  5. 05

    Look at the extras honestly.

    Dental, vision, hearing, fitness, transportation and over-the-counter allowances. These vary a lot. Ask what’s actually covered and how much.

  6. 06

    Think about the year ahead, not just last year.

    A surgery on the horizon, a new diagnosis, a specialist you’ve started seeing? These can change which plan fits.

You don’t have to sort through it all alone.

Friendly support is just a phone call away.
We can help you understand how these pieces fit together, what questions to ask and where to find answers. We won’t recommend a plan and we can’t enroll you, but we can make the process feel a lot less confusing.

Call: 888-336-1312

Talk with a real person who has time for you.

Call Us

Answers to questions we hear most.

Is my doctor in the plan’s network?
  • Search the plan’s provider directory by your doctor’s full name and office address. Some doctors are in-network at one location but not another.
  • Ask about the specific physician, not just the practice.
  • Then call the office to confirm. Directories go out of date.
  • Most HMO plans ask you to name a primary care doctor at enrollment. If you don’t, one will get assigned to you.
  • Check every plan you’re considering separately.
  • Call 888-336-1312 to confirm Complete Health participation.
Are my prescriptions covered?
  • Every plan has a formulary — its list of covered drugs. It changes every year.
  • Drugs sit in tiers, and the same medication can be a low tier in one plan and a high tier in another. Compare the actual copay, not the tier number.
  • Watch for prior authorization, step therapy, and quantity limits.
  • Drugs given in a doctor’s office or infusion center are covered differently and won’t appear in a formulary search — ask about those separately.
  • Enter your exact medications and doses into the Plan Finder at Medicare.gov. It’s free and it’s the best tool available.
What will my out-of-pocket costs look like?
  • Four numbers matter: premium, deductible, copays, and maximum out-of-pocket costs.
  • A $0 premium isn’t free — you still owe your Part B premium.
  • The maximum out-of-pocket is your protection in a bad year. It generally doesn’t include prescription costs or out-of-network care.
  • If you have Original Medicare with a Medigap policy, switching away may be permanent — you may not be able to get that policy back.
  • Help exists with premiums and drug costs. More people qualify than apply.
Are my specialists and hospitals included?
  • Check each one separately – your primary care doctor and your cardiologist may not be in the same network.
  • Include the hospital you’d want to use, plus any therapy, dialysis, or infusion center.
  • Ask whether you need a referral to see a specialist.
  • Ask how care is covered when you’re away from home – this matters a lot if you travel or have a second residence.
  • Emergency care is covered anywhere. Follow-up care may not be.
What extra benefits are included?
  • Dental, vision, hearing, fitness, over-the-counter allowance, transportation and meals.
  • The advertised amount is a ceiling, not a budget — ask if the plan actually pays for what you need
  • Check the network first. Dental and hearing benefits often run through a separate, smaller network.
  • Over-the-counter allowances usually reset each quarter and don’t roll over.
  • Some benefits are only for people with certain health conditions. Ask whether you qualify.
How do I enroll?
  • Enroll yourself at Medicare.gov, call 1-800-MEDICARE, call the plan directly, or work with a licensed agent.
  • Have your Medicare card handy — you’ll need your number and coverage start dates.
  • If you’re in a Medicare Advantage plan, don’t sign up for a separate drug plan. It will cancel your coverage.
  • You can change your mind as many times as you like until Dec. 7. The last choice counts.
  • We can’t enroll you or recommend a plan — but call us at 888-336-1312 with questions.

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