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What Do I Need to Do During Medicare Open Enrollment?

McNair Dallas Law

Medicare Open Enrollment

It’s hard to escape the Medicare ads that fill the airways each fall, when insurance companies vie for beneficiaries’ attention during the annual open enrollment period. Running from Oct. 15 through Dec. 7, this period is when the more than 63 million Medicare beneficiaries can pick a new Medicare Part D drug plan, a new Medicare Advantage plan, or switch from Original Medicare into a Medicare Advantage plan or vice versa.

Any coverage changes made during the Medicare open enrollment period will go into effect Jan. 1, 2022. Money Talks News’ recent article entitled “Medicare Open Enrollment Just Started — Here’s What’s New for 2022” says that most beneficiaries stay with the coverage they have. In fact, seven out of 10 Medicare beneficiaries didn’t compare plans during the 2018 open enrollment period (that’s the most recent for which there is data available, according to research from the Kaiser Family Foundation).

This can be a missed opportunity, despite the fact that it’s tedious to review your insurance coverage. Even if your coverage doesn’t change, your needs might. Let’s first look at what’s new for Medicare Advantage.

Medicare Advantage is an alternative to Original Medicare. It offers some things that Original Medicare doesn’t, such as limited dental and vision coverage. Most Medicare Advantage plans offer prescription benefits, and some offer benefits like meal delivery and transportation help to qualifying members. The average premium for Medicare Advantage will be $19 for 2022, which is down from $21.22 in 2021. That’s the average, and many Medicare Advantage plans have no premiums.

This may make Part C more cost effective than Original Medicare, which beneficiaries often combine with an optional Part D drug plan and optional Medigap supplement plan. However, this affordability comes with a trade-off: many Medicare Advantage plans are HMOs with limited networks of doctors and hospitals. That means that your choice of providers may be limited. In contrast, with Original Medicare, you can see any doctor in the country who takes Medicare.  Beneficiaries can switch between Traditional Medicare and Medicare Advantage, or between Medicare Advantage plans during Open Enrollment.

Note that you should hold on a sec before dropping your Medicare Advantage plan because if you want to switch to Original Medicare and buy a Medigap supplement plan, Medigap plans are medically underwritten. Therefore, the insurer will look at your health records. You might be denied coverage or charged more based on your conditions. Research the options and make sure you can secure coverage before dropping your Medicare Advantage plan.

Now, let’s see what’s new for Medicare Part D, which is a stand-alone Part D drug plan to help cover medication costs. The average 2022 premium for Part D coverage will be $33 per month, up a smidge from $31.47 in 2021. You should look beyond the premium at your total costs because some plans might have a higher premium but better coverage of your prescriptions, meaning lower overall costs.

In addition, look at where you fill your prescriptions, because if you switched pharmacies and your new one isn’t a preferred pharmacy in your plan, it’ll likely mean higher costs.

Reviewing your plan during Open Enrollment in light of your current medications and medical needs can end up saving you thousands of dollars each year.

Reference: Money Talks News (Oct. 19, 2021) “Medicare Open Enrollment Just Started — Here’s What’s New for 2022”

Photo by National Cancer Institute on Unsplash

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