Medicare Open Enrollment Simplified

Medicare is the United States government’s health insurance program for people who are 65 or older. Some people under the age of 65 can qualify for Medicare, too. They include those with disabilities, permanent kidney failure, or amyotrophic lateral sclerosis. 

Medicare helps with the cost of health care. It does not cover all medical expenses or the cost of most long-term care. The program is divided into four parts: 

• Part A: hospital insurance 
• Part B: helps pays for medical services that Part A doesn’t cover
• Part C: Medicare Advantage. If you have Parts A and B, you can choose this option to receive your health care through a provider organization, like an HMO. 
• Part D: prescription drug coverage

When is Medicare Open Enrollment? 

You can enroll in Medicare health and drug plans from October 15th through December 7th. 

Get ready for Medicare’s Open Enrollment with these 3 tips: 

1. Check Your Mail

You may get important notices from Medicare or Social Security. If you’re in a Medicare plan, you’ll get an Annual Notice of Changes (ANOC) telling you of any changes in costs, coverage, or any extra help you may get to pay for prescription drugs. 

You may also get brochures and other marketing materials from insurance companies that offer Medicare health and prescription drug plans. Plans aren’t allowed to call or come to your home without an invitation from you, so be diligent in protecting yourself from Medicare fraud. 

2. Think About Your Medicare Coverage Needs for 2023

Carefully review your current Medicare coverage, and note any upcoming changes to your costs or benefits. Decide if your current Medicare coverage will meet your needs for the year ahead. If you like your current coverage, and it’s still available for 2023, you don’t need to take any action to keep it. 

3. Get Personalized Help in Your Community

You may be able to find free information and events online or get help from health insurance counselors in your area by phone. 

Visit Medicare.gov to sign up to and get important news and updates by email from Medicare. 

How to Change Medicare Plans 

The decision to switch plans is a big one. You’ll shop around, compare costs and benefits, and then possibly pick again. In the end, you may decide to just stick with what you have. 

So, should you keep your Medicare plan? Should you switch to a new Medicare plan? You really only have to answer three questions about your current plan to decide whether to keep it or switch. If you answer “no” to one or more of the three, then you’ll probably want to explore other options. 

1. Will I Have the Coverage I Need? 

To answer this question, you need to look at the benefits the plan provides and learn how your plan could be changing for the next year, if at all. Insurance companies review and may change their Part D and Medicare Advantage (Part C) plans every year. This means that you could have different benefits and services added and/or removed each year. 

That being said, your plan will notify you about any coverage or cost changes in an Annual Notice of Changes letter. Be sure to read it and pay attention to coverage changes that may affect you. Most plans send ANOCs in September. 

2. Am I Comfortable with the Plan Premium and Other Costs? 

Your costs for Medicare can also change year-over-year. Both Original Medicare and private Medicare plans can change their premiums, deductibles, and other costs annually. Those costs will be worth noting. 

• If you have a plan with a deductible, then you’re responsible for paying the cost of your care up to that amount. After that, your plan coverage starts to kick in. Check for any changes to your plan deductible and how that will affect your budget. 
• Copays and coinsurance are charged when you receive a service. 

3. Can I See the Doctors, Hospitals, and Pharmacies I Like? 

Plans could also charge their provider and pharmacy networks from year to year. You need to check your plan details carefully to make sure that your doctor and other providers are still in the network. If they aren’t, you could pay more if your plan considers them to be out-of-network. 

Medicare Eligibility 

Generally, Medicare is available for people who are 65 or older, younger people with disabilities, and people with End-Stage Renal Disease. You are eligible for premium-free Part A (Hospital Insurance) if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. 

You could get Part A at age 65 without having to pay premiums if: 

• You are receiving retirement benefits from Social Security or the Railroad Retirement Board
• You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them
• You or your spouse had Medicare-covered government employment 

If you (or your spouse) did not pay Medicare taxes while you worked, and you are 65 or older and a citizen or permanent resident of the U.S., you may be able to buy Part A. 

If you are under age 65, you can get Part A without having to pay premiums if: 

• You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. 
• You are a kidney dialysis or kidney transplant patient. 

While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for Part B premium every 3 months. 

How to Enroll in Medicare 

Timing is everything, and it’s especially important when it comes to enrolling in Medicare. As you approach 65, you’ll want to enroll during your initial enrollment period (IEP). This seven-month period goes from three months before the month in which you turn 65 until three months after. 

If you don’t sign up during your IEP, you will get another chance to enroll during Medicare’s annual general enrollment period. However, if you enroll at that time, your coverage won’t begin until July. Additionally, because you enrolled late, your monthly premiums for Medicare Part B- which covers your doctor visits and other outpatient services- will likely cost you more. 

2021 and 2022 Medicare Coverage Costs 

Funding for Medicare comes from a variety of sources, including federal government payments, payroll taxes, income taxes on Social Security benefits, premiums paid for health coverage, among others. 

The average premium for Medicare Advantage plans will be lower in 2022 at $19 per month, compared to $21.22 in 2021, while projected enrollment continues to increase. As previously announced, the average 2022 premium for Part D coverage will be $33 per month, compared to $31.47 in 2021.

The 2022 monthly premium for Medicare Part B recipients has yet to be announced; the standard premium in 2021 is $148.50 per month. An increase of about $10 is projected for 2022.

Parting Thoughts

Picking a Medicare plan may not top your list of fun fall activities, but you owe it to yourself to shop if you find that your current plan falls short of your needs.