Open Enrollment Is Here. Are You Ready?

While attending a family reunion this summer, a distant cousin told me all about her “horrible” drug coverage. I told her she should review her options every year because there could be a better plan available for her.

Even if you’re happy with your current Medicare Advantage or drug plan, make sure you review your plan changes to avoid costly, unexpected changes that will take effect January 1st.

Why is it so important to pay attention to Open Enrollment?

You may be happy with the plan you have today, but the Part D drug plan or Medicare Advantage plan you have today is NOT the same plan you’ll have in the next calendar year or the year after. And when you chose that plan it may have been the best at the time but since them a new insurance company could have come into your area offering a plan that was not available before or the company you’re with could have a new plan that is less expensive.

This year there are 3 companies in Maine and New Hampshire that have introduced new plans with lower costs. One company has a new plan that is nearly identical to another plan that is $800 per year more expensive!

Each January 1st marks the start of a new plan year.

A new plan year means insurance companies can – and often do – make changes to their plans that can cost you. If you’re not paying attention and simply let your plan renew, these are changes you’ll have to live with for better or worse in the new year.

Here are some important things that insurance companies can change:

For Medicare Part D Prescription Drug Plans:

  • Your monthly premium.
  • Your annual deductible.
  • Your out-of-pocket co-pays.
  • The drug formulary (listing of medications the plan covers). Just one medication leaving your plan’s formulary can cost thousands over the course the year.
  • The network of pharmacies.
  • The pharmacy cost-sharing.
  • Coverage rule for medications (quantity limit, step therapy, prior authorization)
  • Coverage of medications in the Coverage Gap, commonly known as the donut hole.


For Medicare Advantage health plans:

  • Your monthly premium.
  • Your out-of-pocket co-pays and coinsurances.
  • The annual out-of-pocket spending limit. Each year these limits continue to creep up. Is your plan’s limit going up this year?
  • The network of providers.

Each year, prior to the Open Enrollment Period, your Medicare Advantage or drug plan must send information about changes in benefits and costs for the upcoming calendar year. Take time to study that information.

You can make changes anytime between October 15 and December 7.

If you have concerns about your coverage, you can use the Medicare Plan Finder to compare plans located at www.medicare.gov

Or, if you prefer to have an unbiased review your coverage by someone who has the knowledge and experience to help you choose the right plan and explain all your options just give me a call and I’ll be happy to help you.

Would you like my help?

If you would like to talk to me or schedule a meeting at your home or a nearby meeting place, you can reach me at 207-370-0143 or use my simple form on the CONTACT ME page of this site to send an email message.

The best part about working with me is that it will not cost you anything to meet with me to discuss your options or to review the plans that are available.  I am paid by the insurance companies in the form of a commission if you enroll in a plan.

You will not pay any more than anyone else and you are under no obligation whatsoever to enroll in any plans if you meet with me.  My goal is to help you and I have found great joy in being able to offer my services to people who need my help.

If you are turning 65 this year or retiring, you may have questions.

Call me today and I will be happy to explain all your options and help you compare plans so you can choose the coverage you need for a price you can afford.

Schedule a phone call or an in-person meeting.

I can answer all your questions over the phone or we can meet face-to-face and I can help you with everything you need to know. I have all the forms and applications you need and I can also help you complete them.