It’s open enrollment for Medicare, that time of year when Medicare beneficiaries can find themselves under siege from various insurance companies seeking their business. It’s also the time when experts recommend you review your Medicare coverage to see if you need to make a change.
Open enrollment runs from Oct. 15 through Dec. 7, giving beneficiaries a window in which to review options, including traditional Medicare and Medicare Advantage, the private insurance alternative to the government insurance plan.
During this open enrollment, you may change your Part D or Medicare Advantage plan for 2023, or switch between Medicare Advantage and original Medicare or vice versa.
On Jan. 1, another open enrollment is held only for Medicare Advantage enrollees. During that time, which ends March 31, MA enrollees can change to a different Advantage plan or to original Medicare.
Authorities advise consumers to be wary of promises made by people promoting Medicare Advantage plans, making sure to get anything in writing and to check with medical providers to confirm they are part of the particular plan’s network. Medicare Advantage plans may restrict patients to using in-network providers, while traditional Medicare will cover any provider nationwide who accepts Medicare.
Authorities also warn Medicare enrollees to be alert to possible scams.
How to Compare Medicare Plans
Medicare offers a plan finder to help enrollees compare Medicare health and drug plans. The plan finder provides information about costs and covered drugs, as well as star ratings of various Medicare Advantage and Part D prescription drug plans. The star ratings are updated annually and incorporate the experiences of people who use the plans.
What’s New For Medicare in 2023
New for 2023 will be a limit on the amount beneficiaries are charged for insulin. Starting Jan. 1, plans won’t charge enrollees more than $35 a month. Also, starting in 2023, Medicare will no longer require copays or deductibles for recommended vaccines, including the shingles vaccine.
The administration says costs will go down slightly for Medicare Part B and D, as well as Medicare Advantage, compared to this year. However the cost reduction is significantly smaller than the amount the costs increased for 2022.
The Medicare Rights Center notes that premiums for specific Part D plans and regions will vary. “It is important for people with Medicare to examine their Annual Notice of Change carefully to determine if and how their plan’s costs or benefits are changing and if it makes sense to explore other options,” according to the center.
You should also be aware that people who earn higher incomes may face surcharges for Part B and Part D coverage.
Medicare Part A covers hospital costs, while Part B covers medical services. Part A includes no premiums as long as an enrollee or their spouse paid Medicare taxes for at least ten years while working.
Different Medicare Options
People who chose to keep traditional Medicare may also enroll in a supplemental plan, known as Medigap, to help cover costs like copays. (Note that as of January 1, 2020, Medigap plans sold to people new to Medicare can no longer cover the Part B deductible.)
Traditional Medicare, when not paired with Medigap, does not have a limit on out-of-pocket expenses in a year. Open enrollment is an opportunity to review Medigap coverage to determine if you have the best option for your needs, as well as the one that makes the most sense financially.
Medicare Advantage plans, which are offered by private insurance in place of traditional Medicare, do have yearly limits on out-of-pocket costs.
Medigap policies can’t be paired with Medicare Advantage. If you switch from original Medicare with Medigap to Medicare Advantage and then change your mind, you may not be able to get the same Medigap coverage and may have trouble getting any Medigap policy again.
In general, your first time enrolling in Medicare is your opportunity to get a Medigap policy. After that, you may not be able to buy a Medigap policy, or if you are able, it may cost more because of pre-existing health conditions.
Medicare Savings Programs help people with lower incomes pay Part B premiums and Part A and B deductibles, coinsurance and copayments. According to the Medicare Rights Center, if you qualify for one of the three main Medicare Savings Programs, your Part B monthly premium will no longer be deducted from your Social Security. You will also automatically get the benefit of a program called Extra Help, which helps with Part D prescription drug costs. For information about open enrollment, you can visit Medicare.gov, call 1-800-MEDICARE, or contact your State Health Insurance Assistance Program, which can help you review and compare your coverage and any possible changes.
What if You Want to Skip Medicare Open Enrollment?
While authorities urge an annual review of your coverage, you don’t have to do anything if you’re happy with what you have. If you want to maintain your current Medicare coverage, you do not need to re-enroll.
Elaine Silvestrini has had an extensive career as a newspaper and online journalist, primarily covering legal issues at the Tampa Tribune and the Asbury Park Press in New Jersey. In more recent years, she's written for several marketing, legal and financial websites, including Annuity.org and LegalExaminer.com, and the newsletters Auto Insurance Report and Property Insurance Report.
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