Medicare’s annual enrollment period begins on Oct. 15 and lasts until Dec. 7, but beneficiaries shouldn’t wait until the last minute to review their insurance coverage and make changes.
Retirement Tip of the Week: The wrong Medicare decision – or just one that hasn’t been given much thought – can cost beneficiaries money and stress the following year when they need medical attention. Review your coverage as soon as possible, and check which options make the most sense for your medications and doctor preferences.
There are three P’s to focus on, said Ari Parker, co-founder and lead adviser at Chapter, a company that specializes in maximizing Medicare coverage: providers, prescriptions and priorities. The Medicare options a beneficiary chooses affect all three, and all three affect their coverage in return.
For example, not all doctors may be covered under one option, so someone who wants to see a specific specialist (or more) should make sure they’re in network when switching plans. Beneficiaries should also be hyper-aware of the prescriptions covered under the drug plan they choose. If they choose to travel internationally, or if they expect to be in multiple states for months at a time throughout the year, they should take that into consideration when making Medicare coverage decisions too, Parker said.
Keep in mind what your budget is, and how your insurance fits within that budget, said Christopher Ciano, president of Aetna Medicare. Look at all out-of-pocket costs, premiums, copayments, deductibles and coinsurance. What medication may you be expected to start next year, and how does that fit into your current or potentially new plan? Check that even if you were to stay with the plan you already have, these prices and figures aren’t changing, he added.
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Not everyone needs to switch insurance plans during this period, but they should at least check their current plans as those may have changes for next year. Sticking with your current coverage could make sense, or it could cost individuals hundreds or more dollars a year.
The changes expected next year from the Inflation Reduction Act is another incentive to get serious about Medicare coverage this year. Older Americans won’t see their annual medical costs cut, significantly for some, for a few more years, but they can expect to pay less for insulin beginning next year, Ciano said.
For example, Medicare beneficiaries who use insulin will pay no more than $35 a month for it starting in 2023. Beneficiaries should look at how insulin shaped their Medicare decisions prior to this year and where it fits into their current coverage or the plan they may adopt. Not all plans cover the same insulin products.
Changes during the open enrollment period will go into effect on January 1. The annual enrollment period between Oct. 15 and Dec. 7 allows beneficiaries to switch from Original Medicare to a Medicare Advantage Plan, which is government-approved health insurance private companies offer, or from one Medicare Advantage plan to another.
Medicare Advantage has its own enrollment period,from Jan. 1 to March 31, when people can switch between Medicare Advantage plans or move back to Original Medicare. That second enrollment period for Medicare Advantage is not available for beneficiaries who want to switch from Original Medicare to Medicare Advantage, however. Here’s more information about when switching to Medicare Advantage makes sense, and when it may not.
People who are just becoming eligible for Medicare, such as by turning 65, have their own special seven-month enrollment period, beginning three months before the month of their birthday and ending three months after.
Medicare’s handbook, “Medicare and You,” is already available for 2023, and covers updates for COVID-19, such as eligibility for vaccines and booster shots.