It's Medicare Season! How Can You Take Advantage of Open Enrollment?

It’s that time of year again—Medicare is available for open enrollment from October 15th to December 7th! Medicare open enrollment is an excellent time to enroll in benefits for the first time or adjust your current elections. If you’re eligible for Medicare, you have a 7-month initial enrollment period around your 65th birthday. Signing up outside that window without a suitable reason (qualifying coverage elsewhere, etc.) could result in costly penalties on premiums. So, if you haven’t signed up yet, don’t hesitate. If you need to look for a plan, we can refer you to a local Medicare specialist. In addition, you can also use Medicare’s search tool to find a plan that meets your needs. Now is also the time of year when the 64 million Americans already enrolled in Medicare can make changes to their plan to better fit their needs for the coming year.

Why is Medicare Open Enrollment Important?

Even if you’re content with your current plan, it’s essential to review and see if there are adjustments you should be aware of. After all, Medicare can make annual changes to:

• Cost

• Coverage

• Providers in their network

Information regarding the following year's plan becomes available in October. For example, in 2022, deductibles and copays for Medicare Parts A and B increased significantly. But they also added more plans that cap insulin costs and offer improved access to mental health care. Moreover, the newly-passed Inflation Reduction Act provides Medicare with more negotiation power moving forward, which could make open enrollment even more critical. You typically aren’t allowed to make changes outside of open enrollment, so once the period ends, you’re stuck with your selections for an entire year. That’s why ensuring your plan matches your health and budgetary needs is vital for a successful retirement. 

Two Documents to Review Every Medicare Open Enrollment 

Medicare can be complicated (and intimidating) at first. You may be unclear about determining if you must make changes, but there are specific documents you can review for the next steps.

• Evidence of Coverage (EOC). The EOC is a holistic document that provides details about what your plan covers and how much you will be required to pay starting January 1, 2023. 

• Annual Notice of Change (ANOC). The Annual Notice of Change (ANOC) is a notice informing you of plan changes that will take effect in the upcoming year. It is often sent together with the EOC in late September. 

If your plan changes in the coming year, these documents will let you know. It’s a great idea to sit down with these documents side-by-side to ensure all upcoming changes are accurately reflected. When you receive these documents, review them to see if your coverage still meets your needs. If it does, great! If not, now is the time to make changes.

How Do I Know If I Need to Change or Update My Coverage?

So, how do you determine if your plan doesn’t fit or if you want to make a change?In most cases, you only need to sign up for Medicare Part A and Part B once. What you can change each year is how you get your health coverage or add/switch prescription drug coverage.Generally, people are either covered under one of two Medicare ‘umbrellas’:

• Original Medicare With Medicare Supplement or Medigap Plan. Original Medicare comprises Parts A and B (hospital and medical insurance, respectively). While most people don’t pay premiums for Part A, Part B does carry a monthly premium that can increase based on your income—Medicare IRMAA. But Original Medicare isn’t as comprehensive as you might think, leaving out core coverage areas like dental care, vision, hearing, and more. One option to fill the gap is with a Supplemental Medicare plan. This is a type of insurance you add to Original Medicare to get the care you need. Keep in mind that most Supplemental plans require you to obtain separate Part D (prescription drug) coverage. 

• Medicare Advantage. For an additional premium, Medicare Advantage Plans (or Medicare Part C) offers flexible coverage from private insurance companies that partner with Medicare. Medicare Advantage Plans combine Part A, Part B, and sometimes Part D (prescription drug coverage) into one plan. However, Medicare Advantage can often come with unexpected copays and provider limitations, so it’s essential to read the fine print.

There are advantages to both plans, so ask yourself these questions:

• What are the premiums for your current plan? Are they set to increase? If so, by how much?

• What are your current out-of-pocket costs, and how much will they change in the next year? 

• Do you have new medical needs, like specialist visits, physical therapy, etc.?

• Are you planning on moving or changing doctors?

• Could you cover unexpected hospital costs?

• Do you have any preexisting medical conditions to factor into your decision?

• Are you taking new medications?

Before switching coverage, be sure you fully understand the terms of the new plan. Will you need to get a new medical exam? If so, would that negatively impact your total costs?It’s also important not to remain on autopilot. For example, if you need access to certain medications, it’s best to see if your plan covers that now and make appropriate changes to keep costs down and ensure you get the care you need. To learn more about the differences between Original Medicare, Supplemental Plans, and Medicare Advantage, you can check out this helpful resource from Medicare.gov.

How Can I Update My Medicare Coverage? 

If you decide you want to switch your Medicare Advantage plan, you can use the online portal to find a plan that better suits your needs.If you want to switch from Medicare Advantage to Original Medicare plus a Supplement plan and Part D plan, you can contact your current plan or call 1-800-MEDICARE.If you still have medical coverage through your employer after you retire, consult with them about the changes because sometimes, joining a Medicare Advantage Plan could cause you to lose employer or union coverage.Remember, Medicare doesn’t cover certain expenses, like long-term care. Because of this, it’s important to find additional protection and risk management opportunities to help secure your future. We work with local trusted Medicare brokers and can refer you if you need help reviewing your options.

Making Lasting Financial Decisions

Whether it be Medicare, retirement planning, or investment strategies, it's essential to have a trusted financial advisor who can act as a sounding board and a guide through the complicated financial system. Medicare’s open enrollment period is from October 15th to December 7th, so there’s no time like the present to finalize any changes you want to make.To get started, reach out today.