Question:  What do I need to know about Medicare for 2021?

Medicare open enrollment period is from October 15th–December 7th. It is important to review your plan and make sure it is still the right choice for you. Plans change a little each year and sometimes this may mean they no longer cover a prescription drug you need or may not be the right choice based on your specific health needs. Often people will select a plan based on good reviews from a friend, but in reality each plan needs to the best choice based on your individual health and medication needs. That may be different than your friend’s needs.

Use this open enrollment period as a time to review your own plan and be sure you have the best choice for the coming year. The Health Insurance Counseling and Advocacy Program (HICAP) is funded through the Older Americans Act and is designed to provide free and unbiased counseling, and comparisons on all Medicare Health Insurance and Medicare Prescription Drug Plans. You can reach them at 805-477-7310 to make an appointment for unbiased counseling to compare Medicare plans. They can also help you understand if you are eligible for a low-income subsidy. If your income has changed this year you may want to check these options.

In general, anyone age 65 or older who is a U.S. citizen or a legal resident for over five years is eligible for Medicare. Additionally, you may qualify if you are under age 65 and have a disability. There are two paths for your Medicare, original Medicare or a Medicare Advantage Plan. Original Medicare is made up of Part A to help with hospital costs, Part B to help pay for outpatient care and Part D for prescription coverage. You can also purchase an additional supplemental plan with original Medicare to help with your costs.

If you chose instead to select a Medicare Advantage Plan, all your parts of Medicare are rolled into one plan. These are called Medicare Part C Plans. These plans are provided by private companies that contract with Medicare. The premiums change from year to year and it is important to know what doctors and hospitals are in the network of this plan.  Each path has pros and cons as well as different costs associated with them. If you use HICAP to evaluate plans for you, they will get a list of your prescription drugs and come up with a comparison chart of different plans with costs for your specific prescription needs.

Extra help may be available when there is a financial need, including prescription drug assistance programs, Medi-Cal insurance and Medicare Savings Programs which help with premium and drug costs.  Income eligibility changes from year to year so it is always important to re-evaluate your needs each new open enrollment period.

Medicare publishes an annual guide to benefits called “Medicare and You.” The 2021 version can be found here: This guide has a lot of useful information on the new benefits, the different parts of Medicare and how to make sure you are getting the most out of your benefit. Familiarize yourself and be an active healthcare participant, ensuring you get all your preventative appointments and stay on top of your health.

Martha Shapiro can reached at Senior Concerns at 805-497-0189 or by email at

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