October 29, 2020
Medicare Open Enrollment season is here and runs through December 7th. Just as in past years, open enrollment is a time for people enrolled in Medicare to change their Medicare Part D (prescription drug plan). A new change this year also allows people on dialysis or living with a kidney transplant who are eligible for Medicare to choose to enroll in a Medicare Advantage plan (managed care plan) instead of traditional Medicare if they wish.
Medicare Advantage (MA) plans are offered by private insurance companies that contract with Medicare to provide you with all your Part A and Part B benefits, often also offering additional benefits such as prescription drug coverage (Part D) and dental, vision or hearing benefits. Annual out-of-pocket costs for in-network services are capped – meaning after you pay a specific amount out-of-pocket you do not have to pay additional out-of-pocket costs.
Prior to 2021, Medicare Advantage (MA) plans were not offered to people with End Stage Kidney Disease (ESKD), so you may not be familiar with this option. While MA plans can offer many benefits, it is important for kidney patients to make sure their dialysis facility and transplant center are in-network providers with the MA plan they choose. To learn more about the benefits and considerations of MA plans watch NKF’s recent Insurance webinar.
Medicare Part D plans change every year, so even if you stay in the same plan, the services, providers, and medications that are covered, and their cost, may change. Make sure you review your plan so you are aware of any changes that could affect what you pay for medications.
Research has shown that only 13% of people enrolled in Medicare change their Part D plan, even when doing so could result in better coverage and lower costs. It’s very important that you research plans every year. Don’t assume that if you stay in your current plan that your costs and coverage will stay the same.
Read this document (pdf) to learn more about how to review your Medicare Part D options and why it’s so important. You can compare your options for both Medicare Part D plans and Medicare Advantage plans on Medicare’s plan finder website.
Questions or want more information about insurance? Visit NKF’s Insurance explainer to learn more or contact our NKF Cares Helpline at 1.855.653.2273 or nkfcares@kidney.org.
