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Sun, Oct. 13

Medicare deadline is for those who haven't picked a drug plan

Senior citizens eligible for Medicare who wish to either enroll in, or change, their prescription drug plan, or wish to enroll in, or drop out of, an all-inclusive Medicare Advantage plan, must do so by no later than Dec. 7.

This deadline does not apply to those who wish to either maintain their standard Medicare coverage for hospital and doctors' visits, or those who have a supplement insurance program to bridge the gap between what Medicare pays and what is owed on a bill, said Jeff Wilhelm, the owner of Otto & Wilhelm Insurance Agency in Prescott, a specialist in Medicare and Affordable Care Act programs.

Advertisements about the approaching open enrollment deadline has prompted Wilhelm to field a flood of calls from existing or potential clients who fear they will lose their coverage if they do not take action. He assures Medicare customers with supplemental and prescription drug plans they are happy with "do not need to do anything."

This deadline is just for those who have not yet enrolled in a prescription drug plan - there are 23 different plans - or who may wish to switch coverage based on health and financial needs. The enrollment period also allows Medicare recipients to opt for one of seven Medicare Advantage plans, coverage managed by private insurance companies but that encompass standard Medicare benefits with additions such as vision, dental, and prescription drug coverage.

Each Medicare Advantage plan may have different out-of-pocket costs and deductibles, but are often attractive because the cost for these plans, Medicare C, are generally lower than a non-Medicare supplemental insurance packages, Wilhelm said.

At this open enrollment time, Wilhelm said it is good for all Medicare recipients to evaluate their plans so if they wish to make a change they do so by the deadline.

In some cases, a plan change can save people money, as much as $300 to $1,000 a year, primarily related to prescription coverage, Wilhelm said. On the other hand, though, he said he does not want anyone to feel rushed to switch when there is no need, or financial benefit, to do so.

In 2016, standard Medicare - 80 percent hospital and medical coverage - will be $121.80 a month with the average addition of $33 a month for prescription drug coverage, Wilhelm said.

Medicare is an insurance labyrinth, but Wilhelm assures consumers need not go this alone.

Beyond expert advice from industry professionals, Wilhelm said Medicare's website is a "really nice tool" he and his colleagues rely on to help people navigate the system.

"If people are willing to go through that process, it is very valuable information. It takes the guess work out," Wilhelm said.

Follow Nanci Hutson on Twitter @HutsonNanci. Reach her at 928-455-3333 ext. 2041 or 928-642-6809

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