{"id":1083,"date":"2014-10-15T19:25:50","date_gmt":"2014-10-15T19:25:50","guid":{"rendered":"http:\/\/plinylives.com\/?p=1083"},"modified":"2014-10-15T19:31:39","modified_gmt":"2014-10-15T19:31:39","slug":"open-enrollment-has-started","status":"publish","type":"post","link":"https:\/\/plinylives.com\/?p=1083","title":{"rendered":"Open Enrollment has started!"},"content":{"rendered":"<h2 style=\"text-align: center;\">Today is the big day!<\/h2>\n<h4 style=\"text-align: center;\">The annual Open Enrollment Period (OEP), runs from<\/h4>\n<h4 style=\"text-align: center;\"><strong>October 15 through December 7.<\/strong><\/h4>\n<p>This is when you can make changes to your\u00a0Part D and Medicare \u00a0Advantage coverage.<\/p>\n<p>Use the<strong> Four C&#8217;s<\/strong> to help you to explore your options:<\/p>\n<h1><strong>Cost<\/strong><\/h1>\n<ul>\n<li>What is the <strong>total projected annual cost<\/strong> of\u00a0the plans you are considering?<\/li>\n<li>How much are the <strong>monthly premiums<\/strong> charged by the plans? Have\u00a0they gone up for 2015?<\/li>\n<li>If you have\u00a0the <strong>low-income subsidy (LIS)\/Extra Help<\/strong>, will your\u00a0current plan\u00a0still meet the low-income benchmark in 2015? If not, how much additional\u00a0premium will you have to pay if you\u00a0want to stay in your\u00a0current plan\u00a0or select a different \u201cnon-benchmark\u201d plan?<\/li>\n<li><strong>Is an \u201cextra\u201d premium worth<\/strong> it for a more responsive formulary\u00a0and less need to request exceptions? (Remember LIS people pay the same copays regardless of Part D plan type.)<\/li>\n<li>What about <strong>other costs<\/strong> (e.g., <strong>copays<\/strong>, <strong>coinsurance<\/strong>, <strong>deductible<\/strong>) changing for 2015, and what are the consequences \u00a0for you?<\/li>\n<li><strong>Did you enter the Part D Coverage Gap in 2014<\/strong>?<\/li>\n<li>Do you\u00a0anticipate this happening in 2015? Are you\u00a0taking<strong> brand-name drugs<\/strong> or <strong>generic drugs<\/strong>?<\/li>\n<\/ul>\n<h1><strong>Coverage<\/strong><\/h1>\n<ul>\n<li><strong>Do the plans you are\u00a0considering cover all the drugs you\u00a0believe you\u00a0will need<\/strong> in 2015?<\/li>\n<li>Carefully review the prescribed <strong>strength<\/strong>, <strong>dosage<\/strong>, and <strong>route of administration\u00a0<\/strong>and<strong> restrictions<\/strong> imposed by plans<\/li>\n<li>\u00a0If you received a formulary exception from your\u00a0plan in 2014 to cover a \u00a0drug not on the formulary, bypass utilization management requirements, or\u00a0reduce cost-sharing, what will happen for 2015 \u2013<strong> are there plans that cover\u00a0your<\/strong><br \/>\n<strong>drugs without limitations<\/strong><\/li>\n<li>Also, <strong>call plans to confirm coverage and costs of new-to-market generic drugs\u00a0<\/strong>that may now available and do not appear on Medicare Plan Finder.<\/li>\n<li><strong>Do you want<\/strong> to have your\u00a0health care and prescription drugs covered by <strong>a \u00a0<\/strong><strong>single plan<\/strong> \u2013 then <strong>you\u00a0should review Medicare Advantage<\/strong> options? <strong>Do you\u00a0have \u00a0<\/strong><strong>Medigap, Veterans, or retiree coverage? <\/strong><\/li>\n<li><strong>How do the plans you are considering\u00a0\u00a0rank<\/strong> under the star quality rating system? Are\u00a0any 5-star plans?<\/li>\n<\/ul>\n<h1><strong>Convenience\/Access<\/strong><\/h1>\n<ul>\n<li>To what extent <strong>will the plans under consideration restrict access to the medications \u00a0<\/strong><strong>you need<\/strong> (through step therapy, prior authorization, or quantity limits) in\u00a02015?<\/li>\n<li><strong>Can you\u00a0get your\u00a0medications at a preferred price at the pharmacy of your\u00a0choice?<\/strong> (Or\u00a0at a pharmacy your\u00a0long-term care facility uses?)<\/li>\n<li><strong>Do the plans under consideration offer mail order delivery<\/strong> and are you interested?\u00a0If yes, how do the 4 C\u2019s compare between mail order and \u201cbrick &amp; mortar\u201d pharmacies?<\/li>\n<li>If you traveled this past year, <strong>will you\u00a0be able to get prescriptions easily<\/strong> with\u00a0the plans you\u00a0are considering <strong>while you are\u00a0away from home<\/strong>?<\/li>\n<\/ul>\n<h1><strong>Customer Service<\/strong><\/h1>\n<ul>\n<li>How responsive are the plans under consideration (e.g.,<strong> how do the plans handle any \u00a0<\/strong><strong>problems or questions)?<\/strong><\/li>\n<li><strong>How do the plans being considered help you\u00a0manage your\u00a0medication needs<\/strong> (e.g.,\u00a0<strong>do\u00a0they send refill reminders<\/strong>)? How do the plans\u00a0do Medication Therapeutic Management\u00a0(MTM)?<\/li>\n<li>How can you use the plans\u2019 Overall Plan Rating in the Medicare Plan Finder as a\u00a0factor? <strong>Do you understand how plan ratings are measured and scored<\/strong>?<\/li>\n<\/ul>\n<p>Here is\u00a0other useful information:<\/p>\n<ol>\n<li>This is a great site. Lots of useful information: <a title=\"My Medicare Matters\" href=\"https:\/\/www.mymedicarematters.org\/\">My Medicare Matters<\/a><\/li>\n<li><a title=\"Part D fact sheets by state\" href=\"http:\/\/www.cms.gov\/Center\/Special-Topic\/Open-Enrollment\/Downloads\/Fact-Sheets-2015-MA-Part-D-Landscape-State-by-State.pdf\">Fact sheets for each State<\/a><\/li>\n<li>Don&#8217;t be late:\u00a0<a title=\"Medicare Part D: Late-Enrollment Penalty Premium\" href=\"http:\/\/www.ncoa.org\/assets\/files\/pdf\/center-for-benefits\/part-d-late-enrollment-penalty.pdf\">Medicare Part D: Late-Enrollment Penalty Premium <\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Today is the big day! The annual Open Enrollment Period (OEP), runs from October 15 through December 7. This is when you can make changes to your\u00a0Part D and Medicare \u00a0Advantage coverage. Use the Four C&#8217;s to help you to explore your options: Cost What is the total projected annual cost of\u00a0the plans you are [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[6,158,164],"tags":[159,317],"class_list":["post-1083","post","type-post","status-publish","format-standard","category-information","category-medicare","category-open-enrollment","tag-medicare-2","tag-open-enrollment","czr-hentry"],"_links":{"self":[{"href":"https:\/\/plinylives.com\/index.php?rest_route=\/wp\/v2\/posts\/1083","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/plinylives.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/plinylives.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/plinylives.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/plinylives.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1083"}],"version-history":[{"count":7,"href":"https:\/\/plinylives.com\/index.php?rest_route=\/wp\/v2\/posts\/1083\/revisions"}],"predecessor-version":[{"id":1090,"href":"https:\/\/plinylives.com\/index.php?rest_route=\/wp\/v2\/posts\/1083\/revisions\/1090"}],"wp:attachment":[{"href":"https:\/\/plinylives.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1083"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plinylives.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1083"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plinylives.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1083"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}