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It’s Annual Enrollment Time: Know Your Options
By Vanessa Orr


With the annual enrollment period for Medicare quickly approaching, it’s important that individuals who will be choosing new health plans or prescription plans know what their options are. Unfortunately for those who live in western Pennsylvania, those choices aren’t exactly clear.

“During the annual enrollment period, which runs from Oct. 15 to Dec. 7, individuals who want to choose a new health plan or prescription plan for 2019 may be facing some confusion,” explained John Wells, owner of Medicare Specialists of Pittsburgh. “Tens of thousands of people who have certain plans may not be able to utilize all provider networks. What I’ve seen at recent meetings where we discuss the upcoming year and highlights of new plans is that it is still really unclear as to whether or not people on Highmark plans will be able to use UPMC at all.”

The Pennsylvania Supreme Court recently ruled that Highmark Medicare Advantage members’ access to the University of Pittsburgh Medical Center (UPMC) network will end in 2019.  It is expected that seven UPMC hospitals will leave the Highmark network, with UPMC Children's Hospital of Pittsburgh remaining in the network through 2022.

The good news is that there are other options. “I highly recommend that people look into going back to original Medicare and picking up a supplement that will allow them to still have access to the networks across the country that they would like.”

One of the best ways to determine what plan to enroll in is to for individuals to sit down with a broker and discuss their health care needs, including the medications that they’re taking, to determine what insurance coverage will meet their needs for the coming year.

“People should be setting up those appointments now so that they can get in during October and November,” said Wells. “We will be able to tell them what options are available to them across their provider network, so they know if they can see what doctors they need to see. There are a lot of carriers out there, who provide very good coverage.”

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To learn more, contact Medicare Specialists of Pittsburgh at www.medipgh.com or call (412) 343-0344.



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