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Medicare open enrollment begins today
FOX 26 Consumer Reporter Heather Sullivan has more on the open enrollment and making sure you have the right plan.
HOUSTON - Medicare open enrollment runs from Oct. 15 through Dec. 7, but there are some changes this year that could help seniors save money.
One of the biggest changes, due to the Inflation Reduction Act, is that Part D plans, which covers prescriptions, must cap out-of-pocket costs on covered drugs at $2,000 a year.
"Let's say you're on a few medications that are Tier 3, Tier 4, Tier 5. Instead of going into the doughnut hole, where your co-pays would shoot up to $400 or $500 per month, you're going to have that $2,000 amount and that's the end of it. That's as far as it will go," explained Benefits Coordinator Alex Rischan of the Houston-Galveston Area Council. "It is not inclusive of your drug premium. So it is besides that. But it is going to offer at least $1,000 a year, if not more, in relief to folks at the pharmacy on those medications."
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The cap includes deductibles, co-pays, and co-insurance for covered drugs. But it does not apply to premiums and drugs a plan does not cover, so it's important to shop for the best plan for your needs.
Seniors can also get a payment plan for Part D plans.
"They would balance the bill out through the full 12 months of the year. That way, instead of having this hefty payment at the front, you would pay about $100 to $140 a month, at most, for all of your medications throughout the entire calendar year," said Rischan.
Other big changes include expanded benefits for family caregivers, access to more mental health providers, and Part D plans can cover weight loss drugs if they are prescribed for other purposes, such as diabetes.
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How to select a plan
Seniors can access free help to select a plan:
They can go to Medicare.gov to see which plans include their physicians and medications. You can call Medicare at (800) MEDICARE (1-800-633-4227) for help 24 hours a day, 7 days a week.
Seniors can also get free Medicare benefits counseling from several local and state agencies:
Houston-Galveston Area Council at (800) 437-7396.
Texas Medicare Help Line: Call 800-252-9240 for help with Medicare options, premiums, co-pays, and prescription medicines
Texas Health Information, Counseling and Advocacy Program (HICAP) is a free, unbiased program that can help with Medicare enrollment, finding information, and counseling. You can call them at (800) 252-9240.
The State Health Insurance Program provides free, one-on-one counseling and assistance for Medicare-eligible individuals, their families, and caregivers.
State Health Insurance Assistance Programs (SHIP): Provides unbiased help to Medicare beneficiaries, their families, and caregivers
You can call the Harris Health Eligibility Call Center at (713) 566-6509 for questions about eligibility, applying, renewing, or checking the status of your application.
You can also check out the Your Texas Benefits website to see if you might be eligible for Medicaid or to apply for benefits.