Consumer Connection: October is a Critical Month for those on Medicare

October is a critical month for those on Medicare. With the start of the Annual Open Enrollment Period on October 15^th,those on Medicare have until December 7^th to join, switch, or drop a Medicare Advantage (Part C) or Part D (prescription drug) plan.

Costs, benefits, provider networks and what prescriptions a plan covers in a Medicare Prescription Drug Plan or a Medicare Advantage Plan can change each year. Comparing and evaluating options can help you find the best coverage- and possibly even save money. Despite these annual changes only 3 in 10 Medicare beneficiaries compare plans (as reported by Kaiser Family Foundation (KFF)).

Knowing how important it is to be proactive about your Medicare cover, our top tips to help you make the best choices for your coverage include:

1. Read all mail from your plan or medical provider(s)Read all mail to ensure you are informed of any changes by your plan or provider(s). Medicare beneficiaries receive an Annual Notice of Change (ANOC) each September from their Prescription Drug Plan or Medicare Advantage Plan. This is a summary of changes to the plan (i.e. premium cost, coverage, copays, and service area) that will take effect on January 1 of next year. Some beneficiaries will also receive notice that their plan may not continue next year, and they will need to find a new plan during the Open Enrollment Period.

   If you are in a Medicare Advantage plan you may also receive updates from your medical providers about whether they will remain in your plan’s network.

2. Compare Plan OptionsThe next step is to compare plans, which starts by gathering the following information:

• Your Medicare number (from your Medicare card).
• A list of all your current prescription drugs, including the dosage and frequency.
• The name and address of your preferred pharmacies.
• The names and addresses of your doctors, including specialists, and your hospitals- if you are comparing Medicare Advantage Plans.

Once you have your information there are options available for comparing plans.

• Through the Medicare.gov Plan Finder (gov/plan-compare) you can create and account and compare plan options available in your zip code in 2026. Plan Finder even allows you to add your specific prescriptions and pharmacies. The Iowa Insurance Division through its Senior Health Insurance Information Program (SHIIP) provides tools on how to use the Medicare Plan Finder at shiip.iowa.gov/medicare-open-enrollment-period.
• The Senior Health Insurance Information Program (SHIIP) also provides free, confidential, and unbiased one-on-one Medicare counseling with the support of federal funding. Iowans seeking assistance on completing plan comparisons have access to SHIIP-SMP counselors across the state. Counselors can be found by visiting https://shiip.iowa.gov/find-resources/find-counselor and entering your county, or by calling our consumer line at line at 1-800-351-4664.
• Help from Medicare is also available 24 hours a day, 7 days a week, except some federal holidays, at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

1. Make a coverage decisionReviewing plans ensures you understand key factors that impact your coverage decision- such as premium costs, provider networks (if comparing Medicare Advantage Plans) and which of your prescription drugs are covered. Enrollment in a new plan can be done at Medicare.gov/plan-compare, with a SHIIP/ SMP Counselor, or with Medicare directly at 1-800-MEDICARE (1-800-633-4227).  Enrollments completed between October 15^th to December 7^th are for plans that start January 1.

If after comparing plans you are happy with your current coverage, no action is necessary during the Open Enrollment – you will automatically be re-enrolled for the following year.