For seniors enrolled in Medicare, making the right choices during this year’s open enrollment could save or cost them hundreds of dollars. This is because seniors have the chance to switch to or from Medicare Advantage, which bundles Part A and B with prescription drug coverage.
The annual open enrollment period for these plans runs from October 15 to December 7. Here’s what seniors should know to make the best choice for them.
Check Your Coverage Options
As Medicare beneficiaries near retirement, they face a confusing array of options that includes multiple plans with different coverages, premiums and co-pays. The process can be difficult and time consuming, but it’s crucial to take the proper steps to ensure they are getting the most out of their Medicare coverage. The Medicare Advantage plan market has become especially competitive, and some seniors have found themselves the victim of deceptive marketing tactics. This ranges from insurance agents who wrongly describe coverage to celebrity-filled TV ads touting benefits to mailers disguised as “official” government mail. Before you commit to anything, read this mutual of omaha medigap review and other similar reviews.
While it may seem overwhelming, there are ways to make the process easier. The most important step is to check out the available options. This includes looking at the different Medicare Advantage and Part D plans available in your area, as well as comparing costs and benefits between plans.
Medicare’s website, Plan Finder, can help you find the best plans in your area. To start, enter your zip code and select the type of plan you want to compare. Once you have a list of the available plans, click on each to see details such as monthly premiums and deductibles. You should also consider the cost of drugs and doctor visits.
If you’re already enrolled in a Medicare Advantage plan, you can switch to another MA plan or back to original Medicare during the open enrollment period that starts October 15 and ends December 7. Changes made during this period will go into effect January 1.
Similarly, if you’re enrolled in a stand-alone Part D plan, it’s important to compare your options. Your prescription drug needs can change from year to year, and you may be able to find a better deal on your drugs or a more convenient mail-order program. However, if you’re dissatisfied with your stand-alone Part D coverage, you won’t be able to make changes until next year’s annual Medicare Advantage Open Enrollment Period.
Medicare Open Enrollment is also an opportunity to check if you qualify for any Medicare Savings programs that help with the cost of prescription drugs and other out-of-pocket Medicare costs. The federal government has four programs that offer assistance to people with low incomes, and you can apply at any point in the year.
Consider Your Health Needs
Whether you have Original Medicare (Parts A and B), or a Medicare Advantage plan, it’s important to review your current health and drug coverage each year. That’s because Medicare plan offerings and costs change from year to year, and your own health needs may change, too. The annual Medicare Open Enrollment period is an opportunity to make changes, including changing your Medicare Advantage or Medicare Part D prescription drug plan, or switching from a Medicare Advantage to Original Medicare or vice versa.
You can also make changes to your Medicare Advantage plan during the Medicare Advantage Open Enrollment period, which runs from January 1 through March 31 each year. This time is also a great time to consider adding or dropping supplemental insurance, such as dental or vision care, or a Medicare Supplement (Medicare Part D) drug plan.
When reviewing your options, it’s crucial to keep in mind the importance of choosing a plan that includes your doctors and hospitals. This is especially true for people with Medicare Advantage plans, as many of these plans are organized around networks of physicians and other providers. During this time, you should check the provider directories of any Medicare Advantage plans in which you’re enrolled to see if your preferred doctors are still in-network.
Inflation is squeezing the budgets of many seniors, and changing Medicare plans could help you save money. Additionally, if your financial situation has changed since you signed up for Medicare, it’s a good idea to look at the four Medicare Savings Programs that could help with premiums and out-of-pocket costs.
If you’re thinking about making changes to your Medicare coverage, start by checking out NCOA’s Medicare resources and contact us if you need additional support. We have materials for English-speaking and Spanish-speaking residents, as well as trained advocates to answer your questions via phone or live chat. And if you haven’t done so yet, download the 2022 edition of NCOA’s Medicare & You handbook for more information on enrollment periods and your rights. It’s free, and available in English, Spanish, and Chinese.
Check Your Financial Situation
Whether you’re in Original Medicare and have supplemental drug coverage or are enrolled in a Medicare Advantage plan, open enrollment is an opportunity to reconsider your choices and make changes for the year ahead. While reviewing your options, pay special attention to Medicare Advantage plans because they typically have networks of doctors and other providers (including hospitals) that you can use to reduce the cost of services. These provider directories can change, and it’s important to check that the physicians you rely on remain in your current plan or new one.
Another area to look for changes is the Medicare supplemental insurance, or Medigap policies. Medicare supplemental insurance covers costs that aren’t covered by Original Medicare, like copays, coinsurance and deductibles. Medicare’s annual open enrollment period for supplemental insurance is October 15 to December 7 of each year. You can buy or change a policy at any time of the year, but your new coverage won’t take effect until January 1.
The fall open enrollment period is also a good time to explore Medicare Savings Programs and other state resources that can help pay your Medicare premiums or out-of-pocket costs. You may be able to qualify for Extra Help paying your prescription drug costs or other reductions in your Medicare Part D premium if you have limited income and assets. It’s worth contacting your local county office and asking about the availability of these programs, as the rules vary from state to state. A Social Security representative can also tell you if you qualify for these benefits. It’s important to apply for these programs as soon as you can so that your income and assets are documented and you can begin getting the financial help you need. If you’re eligible, it’s best to sign up for Medicare when you first become eligible – or lose employer-based health coverage – to avoid paying a late enrollment penalty. NCOA’s Medicare & You handbook and other Medicare resources can help you determine if you qualify for these programs. You can even speak with a live representative through NCOA’s online Live Chat service.
Consider Medicare Savings Programs
For the more than 64 million Americans1 currently enrolled in Medicare, fall is a reminder that the annual open enrollment period is about to begin. From October 15 to December 7, seniors can make changes to their Medicare health and drug coverage that will take effect the following year. This includes changing from a Medicare Advantage plan back to traditional Medicare, or vice versa, or switching their prescription drug plans. In addition, beneficiaries can update their Medigap insurance, also known as Medicare Supplement Insurance, which helps pay for coinsurance and deductibles.
Medicare Advantage plans are private programs that offer additional benefits beyond Original Medicare (Parts A and B) such as dental or vision care, gym memberships, or wellness visits. Most of these plans also bundle Parts A and B into a single plan with monthly premiums, as well as a stand-alone Medicare Part D prescription drug plan. Medicare-eligible people can choose from 39 different Medicare Advantage plans this year.
Another important consideration for seniors is whether they are eligible for a Medicare Savings Program, which provides help paying for the Part B and/or Part D monthly premiums and/or deductibles. These programs use state Medicaid funds to support the cost-sharing expenses of low-income Medicare beneficiaries. In 2019, 10.3 million Medicare beneficiaries, or 16% of the total Medicare population, enrolled in these programs. But the share of enrollees varies significantly among states, reflecting differences in asset and income eligibility thresholds, poverty rates, and demographic characteristics of beneficiaries.
To better understand the differences in participation, KFF has created Medicare Savings Program profiles for each state, updated with 2020 data. These profiles show the percentage of Medicare beneficiaries enrolled in these programs in each state, along with other relevant information.
For example, the profile for New York reveals that fewer than one-third of Medicare beneficiaries in the state receive help from these programs. This may reflect that the state uses asset limits when determining eligibility for its Medicare Savings Program, in contrast to most other states that use only income to determine eligibility for their programs.
