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Medicare Open Enrollment Starts October 15 Thumbnail

Medicare Open Enrollment Starts October 15

It’s Annual Health Care Plan Check-Up Time!

Most people find Medicare open enrollment to be confusing and stressful – so stressful that I still remember one of my clients telling me he’d rather have a colonoscopy than deal with open enrollment. The barrage of advertising that turns up in your inbox, mailbox, Social Media and TV this time of year is beyond overwhelming.

Choosing between traditional Medicare, Medigap and Medicare Advantage involves complex trade-offs between up-front premium costs, out-of-pocket limits, and potential restrictions on network providers.

And these choices are not only financial. The wrong coverage can have a serious impact on your health if it means delayed access to care, or if it prevents you from seeing the best possible healthcare provider for your situation.

During open enrollment, you have an eight-week window -- October 15th to December 7th -- during which you can evaluate, review and change your Part D or Medicare Advantage plan for 2023, or switch between Medicare Advantage and original Medicare or vice versa to make sure you’re getting the right kind of coverage at the best price for your health care needs.

What typically ends up happening -- people spend as little time as possible reviewing their options -- leading them to choose the cheapest plan possible without making sure it’s really the right one for them and their needs.  

That’s a big mistake.  And it’s one we want to help you avoid making.

Your Options

If you choose to keep traditional Medicare, you can enroll in a supplemental plan, known as Medigap, to help cover costs like copays. (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 for the year. Open enrollment is your opportunity to review your 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 insurers 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. 

Here’s what you need to know…

Last month you should have received your “Plan Annual Notice of Change.” It’s important for you to thoroughly review that notice. If you didn’t get your notice, contact your plan immediately.

In it you will find information about any changes to your plan – possible increases to costs or changes to coverage areas. The notice will provide you with a comparison of your benefits in 2023 to those you’re currently receiving.

Prescription drug coverage often changes. Be sure to check that your prescription drug plan is still covering the medications you need. If a drug you need is no longer covered, you may want to switch plans. If a drug you take regularly is pushed into a higher tier than it's currently in, your costs are likely to go up.

If you have a Medicare Part D plan, you may pay premiums, deductibles, co-payments, or co-insurance for your prescription coverage. The average monthly premium for a Part D plan is projected to be $31.50 in 2023, though plans vary.

This is also a good time to compare original Medicare and Medigap plans to Medicare Advantage plans.

Advantage plans often cost less – as little as zero -- while offering a broader range of services.

For example, traditional Medicare doesn't cover necessities like dental care, vision, and hearing, but you'll often get coverage for these services with a Medicare Advantage plan.

Another benefit of Medicare Advantage is that many plans offer overseas coverage -- traditional Medicare does not.

If you have Medigap coverage, foreign travel coverage kicks in after a $250 deductible and is only meant to cover emergency care. Also keep in mind that Medicare Supplement foreign travel coverage only applies to emergency care expenses within the first 60 days outside of the United States.

If you're planning to do a lot travelling outside of the US in 2023, that could be a good reason to switch to an Advantage plan.

On the other hand, if you’re considering switching to an Advantage plan, the plan you choose can restrict you to using in-network providers, while traditional Medicare will cover any provider nationwide who accepts Medicare.

You should check with your preferred medical providers to confirm they are part of a particular plan’s network before you sign up for a new plan.   To help with your research, here are some useful resources to assist you.

Recommended Medicare Resources

The Medicare Plan Finder is the official government website that posts stand-alone prescription drug and Medicare Advantage plan offerings to help make it easier for you to compare coverage options and shop for plans. https://www.medicare.gov/plan-compare/

The State Health Insurance Assistance Program network provides free one-on-one assistance in every state. These are federally funded programs staffed by trained volunteers; use this link to find yours: https://www.shiphelp.org/

The Medicare Rights Center offers a free consumer helpline at 800-333-4114.

If you are local and have questions about open enrollment, how different plans work, or which plan is best for you, please reach out to our preferred Medicare Expert, Kevin Heath from MTD Benefits to schedule a no-obligation consult.  Our clients just love working with him. Kevin and his team will help you find the best program for your needs. https://www.mtdbenefits.com/

Depending on your individual situation, doing your research now can help you get the right supplemental Medicare coverage for your needs at the best price.