Aug 7, 2018 By Jim Blair for The 4 min read

The Annual Enrollment Period (AEP) for Medicare is right around the corner.

Insurers will begin to notify their customers with information on their plans for next year. Medicare restricts release of that information prior to Oct. 1, 2018. Most insurer’s mail the info to arrive the first week in October, but it always arrives much earlier than that. This update is called the Annual Notice of Change. It is really important that you read these changes or discuss any changes with your broker.

There is one big change for 2019 that will affect a lot of people. The Medicare contracts for our two largest insurers, Highmark and UPMC, will expire mid 2019. That means that access to some doctors, hospitals and other providers will change. At this point, we do not know to what extent that will affect customers with certain plans. You will need to discuss those changes with your broker during the AEP to be sure the providers you use will still be available to you.

In other health care news, the Affordable Care Act (ACA), will still be available in 2019 here in Pennsylvania and the two big insurers will have plans on the Exchange. There may be other insurers as well, but so far just Highmark and UPMC are offering plans. The Department of Insurance has announced a very small rate increase, which will be welcome news to people who are getting tax credits and cost sharing. The mandate to have ACA coverage will end Jan. 1, 2019 and of course there will be no penalty for not having the ACA coverage. We are waiting to see what other plans will be available that may be more affordable for people who do not get tax credits and cost sharing.

People who have Part D prescription coverage, either included in their Medicare Advantage plan or a standalone drug coverage, will see a further shrinking of the infamous Donut Hole. The Donut Hole will slowly go away over the next few years. As it stands now, you pay a percentage of the cost of your prescriptions in the Donut Hole. That percentage is shrinking in 2019.

If you are turning 65 this year or next, or if you are retiring, you will want to start looking at your options about three months before either of the above. You will be automatically eligible for Medicare when you turn 65, but if you are still working and covered by your employer, you won’t need Part B. If you are retiring, you will need part B even if your employer continues to provide you with coverage.

If you currently have Medicaid and are turning 65, or have become eligible for Medicare with limited income, you may be eligible for extra help with both Part B and Part D. You could be eligible for a special needs plan, Pace or Pace Net. Even if you are not eligible for Medicaid, there are a number of options available for people with limited incomes and or chronic medical conditions. Seek out a broker in your area to help you, contact the Pennsylvania’s Department of aging, or call Social Security at 800-772-5397. If you need help with the cost of your prescriptions, and you are 65 or older with a limited income, call PACE at 800-225-7223.

As I have said in previous columns, there is no cost for seeking help from a broker or one of the agencies mentioned. There are a lot of programs out there to help you with the cost of your health coverage — take advantage of them.

Jim Blair is an insurance broker located in Speers. You can reach him at jimblair1078@gmail.com.