This fall, it is especially important to check your health insurance coverage. That’s because in 2017 most premiums are going up sharply—in some cases, by as much as 26%. On top of that, drug insurance plans are expected to raise their monthly premiums and/or cut their lists of covered drugs. Even the doctor you use may no longer be part of your plan! Plus, many Medicare Advantage plans are shutting down.
The good news is that this is the time of year that Medicare, insurance provided under the Affordable Care Act (ACA) and even many private employer insurance programs allow you to switch policies or insurers without penalty during what they call “open enrollment” season. The exact dates to make changes vary by the type of program you are in. For example, this year, you can make Medicare changes (such as buying a different supplemental policy…or changing your Medicare Part D drug plan) between October 15 and December 7. Switches to ACA (also known as “Obamacare”) plans can be made from November 1 through January 31, 2017. To avoid any missteps…
- Don’t make assumptions about coverage. It’s a mistake to assume that what your plan currently covers will be covered again next year. For example, many plans are dropping expensive name brand–drug coverage and requiring you to use a generic version (unless your doctor can make a strong case otherwise). In some instances, expensive new drugs (that treat hepatitis, cancer or multiple sclerosis, for example) may not be covered at all. What’s more, doctors across the country are dropping out of certain plans, complaining that they are not being paid enough. Even more alarming, entire plans are being dropped, leaving you to find a new insurer to meet your needs. To protect yourself: Make a list of all your current medications, doctors and services you need covered (such as vision, dental and/or mental health). When your insurer sends out 2017 rates and coverages (usually in October), check to make sure that the services you need are still covered. Call your insurer to find out if your medications will be covered. And call your doctor(s) to double check that he/she will be participating in 2017 (insurance company lists of in-network doctors, even on their websites, are notoriously out of date).
- Go shopping! If you’re on Social Security, any Cost of Living Adjustment (COLA) for 2017 is likely to be less than 1% (or about $10) per month for the average beneficiary. But health insurance premiums are expected to rise from 4% to 26% in many Medicare Advantage plans and ACA plans. Even traditional Medicare supplemental policies and Part D (drug) plan premiums are expected to see steep premium increases. So be prepared to shop around for the best plans that you can afford. Action step: To find out what plans are available to you, call your state insurance department (or check its website) and ask for contact information for approved health insurance plans, including Medicare supplements, Medicare Advantage plans, private insurance plans and Health Exchange (ACA) plans. If you are on Medicare, call 800-633-4227 for help finding coverage and/or answers to your questions. And if you are employed, be sure to explore the insurance options offered by your employer to choose the best plan for your needs.