Medicare Open Enrollment Period (OEP) January 1 to March 31


It is the time of year when:

  • If you are not currently enrolled in either a Medicare Advantage Plan (Part C) or a Medicare Prescription Drug Plan (Part D) you can enroll, and you cannot be declined.
  • If you are already enrolled in a Medicare Advantage Plan (Part C) or a Medicare Prescription Drug Plan (Part D) you can switch to a different plan or company.

Please note with Medicare Advantage (Part C) there are no restrictions regarding pre-existing conditions, so you do not have to worry about your treatment or care if you choose to change to a different plan.

Medicare is Medical Insurance for people age 65 and above and certain people who have been receiving Social Security Disability Insurance for longer than 2 year.

If you are happy with your current plan unless you’ve received specific notification from your Insurance Company there is nothing for you to do, your coverage will automatically renew. However, if you have not already, I encourage you to review your Annual Notice of Changes (ANOC). Every year plans make many changes and it is important that you are aware of these changes, no one likes to be surprised. There are also changes to Doctor networks, and Drug formularies, so it is important that you take a few minutes to review these changes.

In 2021 there are some exciting changes you want to be aware of:

    1. If you use Insulin you will be happy to know your cost will decrease. Copays for insulin will be reduced to $35/month. Yippee!
    2. Also the donut hole in gone, you will not get that sudden shock to your budget in the middle of the year. When you spend $6,550 you will enter the Catastrophic Level and your copays will be much less. Thanks to the a Part D Senior Savings Model, which most of the available plans (1,750 standalone Medicare Part D prescription drug and Medicare Advantage plans) will participate in.
    3. Acupuncture which was not a Medicare covered service will be in 2021.
    4. Many plan have enhanced Dental Benefits, with plan offering dental services up to $2,000 pcy. So if you need crowns, bridges and or root canals you will have plans that allow for these services.
    5. End Stage Renal Disease (ESRD) which was automatic rejection, (the only disqualifying illness), beginning in 2021 it is an accepted condition.

As you know, every year I am required to go thru considerable training and recertification to explain these plan changes, and since I’ve been helping people since 1993, so I have the expertise to answer your questions.

If you have friends, relatives or neighbors that have questions regarding their Medicare Benefits please share my name with them and ask them to give me a call. I will be happy to help.

Since I am a broker, I am not tied to any one company so I can offer you advice based on your particular needs and concerns.

Here is brief synopsis of some of the plan options available in 2021


Medicare Advantage Plans (Medicare Part C)

Has done some great plan changes 2021 –

    Reduced copays and improved prescription drug benefit.
    Still offer Therapeutic Massage (6 visits pcy with $20 copay)
    Over-the-Counter Benefit ($40/qtr)

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Has made some nice changes for 2021.

Plan include

  • Dental - Up to $2,000 Annual Limit
  • Vision - Up to $300
  • Silver Sneakers
  • Travel Benefit
  • HMO & PPO plans

HMO – Benefit Summary

PPO - Benefit Summary

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has remained a strong provider of coverage. Always one of my favorite providers.

  • $0 premium
  • $0 copay for PCP Office Visits
  • $0 copay for 90 days’ supply of mail order generic drugs
  • Acupuncture/Naturopath/Chiropractic
  • Vision
  • Preventive Dental
  • Hearing
  • Silver Sneakers
  • $25 every 3 months for Over the Counter Drugs

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You can’t go wrong with Premera a welcome name in the Pacific Northwest. Offering several plan choices and one of the largest provider networks making them a strong provider

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Many are in love with the simplicity of vertical integration. Offering 4 plans with prescription drug coverage and one without.

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Most Medicare plans are very similar, only the additional benefits vary. Amerigroup offers many additional benefits that make them different than the others. Here are a few:

  • Vision
  • OTC coverage – $135/qtr - Get a credit card which can be used at Walmart, Walgreen and more
  • Personal Emergency Response System – (I’ve fallen and can get up)
  • Hearing
  • SilverSneakers®
  • Prescription Drugs
  • LiveHealth Online
  • Routine Physical Exam

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a couple of exciting plan option with a very generous benefits. They also offer a $0 premium PPO for people that don’t like to get referrals

  • Dental Services - The dental benefits on this plan include coverage of preventive and comprehensive services up to $1000, including but not limited to cleanings, x-ray(s), oral exams, fluoride treatments, fillings, dentures or a bridge or a crown and a root canal.
  • Hearing Services -The hearing benefits on this plan cover, but are not limited to, routine hearing exams, hearing aid fittings and evaluations, and up to $2000 for 2 hearing aids per year with a maximum of $1000 per ear.

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Medicare Supplement / Medigap Plans

Medicare Supplements are not Medicare Advantage Plans. You can enroll into a Supplement or Advantage Plan. Many people enroll into a Supplement because:

    They have lower maximum out of pocket maximum cost than Medicare Advantage Plan.
      They do not have provider networks, so your doctor is never out of network

    They do not include Prescription Drug Coverage or many of the extra benefits provided in Medicare Advantage
    Typically, they have higher monthly premiums than Medicare Advantage.

Plan F – all medical/doctor cost are paid, you pay nothing (only available to those eligible for Medicare prior to 2020)

Plan G – all medical/doctor cost are paid except the Medicare Part B deductible of $198

High Deductible Plan F – all medical/doctor cost are paid after you pay $2,340 deductible.

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Medicare Part D (Prescription Drugs)

Prescription cost can vary widely. Why not send me your list of drugs to determine if you are with the best plan? Click Here to send list

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Elixir RxPlus

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Asuris Medicare Script Basic
Asuris Medicare Script Enhanced

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SilverScript SmartRx
SilverScript Choice
SilverScript Plus

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Humana Walmart
Humana Basic
Humana Premier

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WellCare Value Script
WellCare Wellness Rx
WellCare Medicare Rx Value Plus
WellCare Classic
WellCare Medicare Rx Saver
WellCare Medicare Rx Select