Autumn isn’t usually thought of as a time for new beginnings, but every fall, Medicare plan enrollees get the chance to start over—at least with regard to their healthcare coverage. During Medicare open enrollment (also known as the “annual election period,” or AEP) enrollees can take a second look at their existing coverage, decide if that’s the best plan, and make changes if needed. They may decide to change from Original Medicare with Part D supplemental drug coverage to a Medicare Advantage plan, or vice versa. If everything is working well, of course, enrollees don’t need to make any changes.
The Medicare open enrollment period runs from October 7 to December 15 in 2022, as it does every year. However, there may be an extended opportunity to enroll or make changes in locations where FEMA has declared an emergency or disaster. That may be particularly relevant this year in Florida, which has a high population of retirees and which is still reeling from Hurricane Ian.
What Changes Can You Make During Open Enrollment?
In addition to being able to change from Original Medicare to Medicare Advantage or from Medical Advantage to Original Medicare, you can switch between different Medicare Advantage plans, or switch between different Medicare Part D prescription drug plans.
If you didn’t enroll in a Part D plan when you originally became eligible for Medicare coverage, you can do so now. However, you may have to pay a late-enrollment fee if you have not maintained other creditable prescription drug coverage. If you have a stand-alone Part D Medicare prescription drug plan, you will not be able to make any changes to it after the close of open enrollment until the next open enrollment period.
Are There Any Changes to Plan Costs for 2023 Medicare Coverage?
Seniors will be glad to learn that premiums for Medicare Part B (the part of Medicare that covers care from doctors, outpatient providers, and home health care) are decreasing for 2023 plans. This is the first decrease in more than a decade. Average Part D (drug coverage) premiums are also expected to decrease slightly.
The deductible for Medicare Part A (hospitalization) will increase, as will Part A premiums for those who have to pay for Part A. For those enrollees with Medicare Advantage plans, the allowable cap on out-of-pocket costs will go up, to $8,300 for in-network costs. However, individual plans are not required to raise their out-of-pocket caps and it is expected that most will remain well below the $8,300 limit.
How to Tell if Your Medicare Plan is the Best One for You
Obviously, you don’t have to change plans during Medicare open enrollment. In fact, most Medicare beneficiaries do not make a change during open enrollment. If you don’t, your existing coverage will automatically renew for the coming year. That might sound fine if you have generally been satisfied with your current plan.
However, just because you like the plan you have doesn’t mean you’re going to continue to be satisfied with it. Plans frequently change their provider networks and drug formularies (lists of covered medications). What that means is if you depend on a particular medication, or it’s important to you to see a particular doctor, you need to confirm that your plan will cover them in the coming year.
Comparing plans might involve a little effort, but that effort can pay off by saving you money or ensuring that you don’t have to switch medicines or treating physicians. Many seniors don’t compare plans because they’re not sure how to, especially if they don’t have ready access to a computer. Even those Medicare beneficiaries who do have a computer might not know where to start.
It can be helpful to explore your Medicare coverage options on the Medicare.gov website. If you’re not able to do that, or not comfortable online, you can call Medicare for guidance. If you are considering switching to a Medicare Advantage plan from Original Medicare, you’ll want to ask certain questions, such as:
- What percentage of costs will I have to pay for services and supplies?
- Are my preferred doctors in-network for this plan? If not, how much extra will I have to pay in order to continue seeing them?
- What benefits does this plan offer that Original Medicare does not? Is there an extra charge for those benefits?
The website or print publication for any plan you’re considering should have the answers to those questions. If not, you should contact the plan directly to get the answers.
To learn more about Medicare enrollment or Medicare coverage, contact Estate Planning & Elder Law Services to schedule a consultation. If you need help changing your health insurance coverage, including your Medicare coverage, we can connect you with trusted professionals who can assist you.