Navigating Medicare choices can often feel overwhelming, especially as costs rise and plan details change every year. To help individuals and families make sense of their coverage options, Tammy Anderson, owner of Senior Health Services/Senior Benefits Consulting in Montgomery, shared essential advice on what to look out for during Medicare's annual enrollment period, how to spot common scams and why working with a local professional can make all the difference.
When is Medicare's annual enrollment period?
Medicare’s annual enrollment period runs from Oct. 15 through Dec. 7.
Changes made during this timeframe take effect for the upcoming year, and you cannot make changes to your plan once the annual enrollment period ends.
What should people review in their Medicare plan each year?
Even if you are completely happy with your current health care coverage, skipping plan reviews can lead to unexpected costs.
"This time of year is when people need to review their prescription drug plans and their Medicare Advantage Plans because there will be network changes and prescription drug changes,” Anderson said.
She noted that coverage changes occur because of inflation, claims and updated regulations. To help alert individuals about these changes, insurance carriers send out an Annual Notice of Change in the mail, which details updates to copays, covered medications and doctor networks.
How can people spot Medicare scams and fraud attempts?
Phone calls and junk mail increase significantly during the annual enrollment period. Identifying legitimate communication versus potential fraud is critical to keeping your personal information safe.
"One thing that's really important for everybody to understand is that Medicare never calls people,” Anderson said. “There are a lot of phone calls, and it's AI bots and/or scams of some sort saying, 'We're calling from Medicare,’ or ‘We're calling about your Medicare card. Did you receive a new plastic card?’ Every one of those phone calls is illegal unless the person specifically asked to be called by the other party."
Accidentally confirming personal details over the phone can lead to being fraudulently enrolled in a new plan without your knowledge.
When checking your mail, official notices will only come from three primary agencies:
Official Annual Notice of Change letters will come directly from your current insurance provider. Unfamiliar mail asking for personal details or offering unsolicited changes can be discarded.
What are the benefits of working with a local Medicare agent?
"With local agencies, … you're not getting a call center; you're getting someone local who knows the plans in the area, knows who accepts the plans and knows current problems that some might be seeing on those plans,” Anderson said. “If you call a call center, [the plan they recommend] might be a bad choice for your area, because they're not local. Those call centers are just trying to enroll massive amounts of people.”
Senior Health Services/Senior Benefits Consulting provides free personalized, year-round assistance. Rather than focusing on sales, local agents prioritize education, taking time to understand a client's specific doctors, medications, health concerns and budget before guiding them toward a plan.
How can local agencies assist employers and older workers?
Local agencies also partner with business owners to help with employee benefits. As more people work past age 65, staying on traditional group health insurance can become very costly for both the employee and the business.
Because employers are legally restricted from directly telling older employees to transition to Medicare, agents can step in to present educational sessions. Transitioning eligible workers from high-deductible group plans to Medicare often lowers out-of-pocket medical bills for the employee, while reducing overall insurance costs for the employer.
What should you keep in mind before booking an appointment?
Because the annual enrollment period is short and demand for guidance is high, scheduling an appointment early is key. Calendars often fill up two to three weeks in advance during this time.
Those interested in learning more or booking an appointment can find resources here:
Phone number: 832-334-1124
Address: 14729 Hwy 105 W., Ste. 120, Montgomery
Frequently asked questions
When is Medicare's annual enrollment period, and what can I change?
Medicare's annual enrollment period runs from Oct. 15 through Dec. 7. During this window, individuals can review and change their Medicare Advantage plans and prescription drug plans. Any changes made take effect Jan. 1 of the following year, and no modifications can be made once the enrollment period closes.
How can I spot Medicare scams during the enrollment period?
Medicare never calls beneficiaries. Any phone call claiming to be from Medicare, including calls about your card or coverage, is a scam unless you specifically requested to be contacted. Confirming personal details over the phone can result in being fraudulently enrolled in a plan without your knowledge. Legitimate mail comes only from the Centers for Medicare & Medicaid Services, the Department of Health and Human Services or the Social Security Administration. Your Annual Notice of Change will come directly from your current insurance provider. Unfamiliar mail requesting personal details can be discarded.
Why should I review my Medicare plan every year, even if I'm satisfied?
Coverage details change annually due to inflation, claims data and updated regulations. Copays, covered medications and in-network doctors can all shift between plan years. Insurance carriers are required to send an Annual Notice of Change letter detailing these updates.
What's the advantage of working with a local Medicare agent versus a call center?
Local agents know which plans are accepted by doctors in your area and are aware of current issues specific to local networks. Call centers handle high volumes of enrollments nationally and may recommend plans that are a poor fit for your region. Montgomery's Senior Health Services offers free, personalized assistance year-round, focused on understanding your specific doctors, medications, health needs and budget before recommending a plan. Because calendars fill two to three weeks in advance during the enrollment period, scheduling early is strongly recommended.
The above story was produced by Senior Multi-Platform Journalist Sydney Heller of Community Impact's Storytelling team, with information solely provided by the local business as part of their "sponsored content" purchase through our advertising team.