SIDNEY – Medicare enrollment is a complicated process, Mary Leep-Pichert said, but individuals can save a lot of money by educating themselves and utilizing Ohio Department of Insurance resources.
Leep-Pichert, an Ohio Senior Health Insurance Information Program community liaison, spoke to the Shelby County Chapter of the Public Employee Retirees Inc., Thursday afternoon at the Sidney Veterans Center. Medicare open enrollment is Oct. 15 through Dec. 7, so individuals need to start reviewing their 2020 plans, she said.
“I put a lot of miles on my car to drive out and talk to good folks like you every day about Medicare and help you understand it because it’s not complicated at all, is it?” Leep-Pichert said, prompting chuckles from the audience. “That’s right, I have job security. It’s pretty complicated.”
During the open enrollment period, anyone on Medicare can make changes to their Part D Drug Plan or Part C Medicare Advantage Plan. Individuals should look at their drug plans each year to see if they want to make changes, Leep-Pichert said.
“I always feel like people can spend more money on their drug plans than what they need to,” she said. “So I always try to educate folks on how they work. Do I wish they were straightforward? Yeah. And easier? Yeah. But they’re not.
“Be a good consumer and look at your plans and make sure that you’re just not going to find out in January that it doesn’t work for you because then you get to wait until next open enrollment.”
Private insurance companies sign one-year contracts with Medicare, meaning each year they can change monthly premiums, deductibles and drug formularies, all of which can greatly increase the cost for consumers.
“I just think it’s pretty hard because there are so many plans,” Leep-Pichert said. “There’s going to be 28 drug plans next year to choose from – 28. So it could be really hard to go through every single one of those plans with your list of meds, trying to figure it out.”
Ohioans can visit the official Medicare website, medicare.gov, for assistance or they can contact OSHIIP, a state government agency that provides free health insurance information and services for people with Medicare.
“We don’t sell insurance,” Leep-Pichert said. “We are the regulators of insurance in the state so we give unbiased information about Medicare.”
The OSHIIP call center is available Monday through Friday from 8 a.m. to 5 p.m. It’s staffed by Ohio Department of Insurance employees in Columbus.
“The easiest thing to do is probably just give us a call at the Department of Insurance, our OSHIIP division,” Leep-Pichert said. “Like I said, real, live people answering the phone. A lot of those folks have been working in insurance and Medicare for 20-plus years. So these are the experts.”
Medicare enrollees should have a list of their medications when they call OSHIIP, which can review plans and give individuals an idea of what medications would cost.
Leep-Pichert highlighted a Humana Walmart Prescription Drug Plan, whose premiums are more than doubling in 2020 as an example of the need to review Medicare plans.
“You folks really need to look at that because your premium is going to be more than doubled,” she said. “You don’t need to pay that.”
When enrolling in Medicare, individuals also should pay attention to pharmacy networks and formulary tiers. Those can change from year to year as well.
“I honestly don’t think there’s a lot of information out there about the plans and their pharmacy networks,” Leep-Pichert said. “If it’s in the network, there’s also another subcategory of a preferred (pharmacy). It’s crazy. There’s a lot to know.”
Consumers can consult with their doctors and pharmacists, Leep-Pichert said, or utilize services such as GoodRx. Sometimes individuals can get better prices on medications directly from a pharmacy instead of going through their Medicare drug plan.
“Be a good consumer,” Leep-Pichert said. “I ask every time I go (to the pharmacy) with (my mother-in-law) Laverne, ‘What’s your price for this medication?’ And sometimes it’s cheaper, and I’ll say, ‘I’ll take that price.’”
Individuals also need to be aware of Medicare scams. Some scammers have visited senior centers and offered DNA testing. The scammers then bill Medicare for their fraudulent services despite not actually performing the tests.
“Medicare fraud … in the billions. In the billions of dollars … with a B, billions,” Leep-Pichert said. “Medicare fraud in the billions is more than the entire budget for NASA.”
For more information, call OSHIIP at 800-686-1578, visit the Ohio Department of Insurance website at https://insurance.ohio.gov or visit the Medicare website at https://www.medicare.gov/.
