| Tue, Oct 23, 2012 @ 09:00 AM

OEP Boot Camp: Consider Your Health Care Budget

Posted by Medicare Made Clear

oep open enrollment information boot campThe second in a 6-post series designed to help you make informed Medicare choices for 2013

The Medicare Open Enrollment Period (OEP) gives you a chance to change your coverage choices, if you choose. You can also choose to stay with what you have. OEP happens every year from October 15 through December 7.

How do you decide whether to make changes? Well, that takes a little homework. Just think of this Boot Camp series as your study guide.

In the last post, we talked about how changes in your health status may affect your coverage needs and choices. Today we’re going to look at the cost of your coverage and care. Changes in your plan’s cost-sharing terms or in your personal finances may lead to considering a change in your coverage.

Check for Changes in Plan Costs

Original Medicare and most private Medicare plans update costs every year. Medicare or your plan will notify you of any changes in the weeks leading up to the Open Enrollment Period. Private plans send out an Annual Notice of Changes to members. It’s very important to read any plan materials you receive at this time. You can also check your plan’s web site or Medicare.gov for 2013 plan information.

It can be tempting to focus on premiums alone when looking at Medicare costs. But other out-of-pocket health care costs need to be part of the equation, too. Deductibles, copays and coinsurance amounts can add up. For example, if your copay for doctor visits increases, then you will pay more every time you go in. The same is true of drug copays. If the amount increases, then you pay more for every refill.

You may want to write down any cost changes in your plan terms and the amounts. Note also if your plan places a limit on what you may have to pay out-of-pocket. Add this information to your Medicare file. If you haven’t yet started a file, you might want to do so now.

Look at What You Spent

Your health care expenses over the past year can provide a baseline for considering your health care budget going forward. Research your records to see what you spent in premiums, deductibles, copays and coinsurance. You may be able to get statements from your clinic, hospital and pharmacy showing all your payments. Collect all of this information and keep it in your file. It may be very helpful when comparing coverage choices.

You also need to take an honest look at how health care expenses fit into your budget. Were you able to pay last year’s bills without hardship? Are you expecting any changes in your finances for the coming year? How might these changes affect your health care budget?

People with limited income and assets may be able to get help with their Medicare costs. Many people who qualify don’t take advantage of the federal and state programs set up to help them. These include Medicaid, the Medicare Savings Program, Programs of All-Inclusive Care for the Elderly (PACE) and others.

You can get more information about financial help with Medicare by calling Social Security at 1-800-772-1213, TTY 1-800-325-0778, 7 a.m. to 7 p.m. local time, Monday through Friday.

Now What?

So far, this series has focused on how changes in personal health status or plan costs can affect Medicare coverage choices. Hopefully, you’ve started to gather important personal information that will help inform your decisions. In upcoming posts, we’ll look at provider networks, drug coverage and more.

The Medicare Open Enrollment Period is underway. You have from now until December 7 to change your coverage choices, if you choose. In addition to this blog series, you can get help from these resources:

  • Medicare.gov, where you can download a copy of Medicare & You 2013, search for plans and find other helpful information

  • Private health insurance company web sites for information about 2013 Medicare Advantage (Part C) and Medicare prescription drug (Part D) plans

  • The 2013 Annual Notice of Changes mailed to you from your Medicare Part C or Part D plan, if you’re currently enrolled in one

  • A licensed health insurance agent in your community who can discuss all your plan choices with you

Be sure to report back to OEP Boot Camp for our next topic, Review Your Current Coverage. Our goal is to help you make informed choices during the Open Enrollment Period.

For more information, contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. If you have questions about Medicare Made Clear, call 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, seven days a week.


Medicare Costs: Get the basics on costs for Parts A, B, C and D.

Medicare.gov: Visit the official U.S. government site for Medicare.

Review Your Health and Budget Needs: Get more help in understanding your needs.


Read other posts in this series:


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