Medicare Open Enrollment: What Beneficiaries Need to Know
As the end of the year approaches, Medicare beneficiaries have until Dec. 7 to change their Medicare health and prescription drug coverage for the upcoming year through annual open enrollment. This year, there’s even more reason to pay attention, as financial assistance for prescription drug coverage is set to expand starting Jan. 1.
“It is important for people to check and see if they could be eligible for financial assistance to help pay for premiums, to pay for co-pays,” said Meena Seshamani, director of the Center for Medicare at the Centers for Medicare and Medicaid Services.
Notably, starting in 2024, people who face high prescription drug costs will not have to pay anything out of pocket once they hit the catastrophic phase of their benefits, thanks to new prescription drug legislation. Additionally, Medicare beneficiaries who take insulin currently do not have to pay more than $35 per month for covered prescriptions, and they can access recommended vaccines at no out-of-pocket cost.
“Medicare open enrollment is so important because options change every year, and people’s health needs and their financial situation changes every year,” said Seshamani. For beneficiaries, this is an opportunity to save.
Medicare open enrollment is when beneficiaries can shop around for health plans and prescription drug coverage that better meet their needs. Health and drug plans make changes every year, so it’s wise to revisit your selections to see which plans match your needs when it comes to cost and coverage, as well as the providers and pharmacies that are in network.
Beneficiaries on original Medicare may choose to add prescription drug coverage by signing up for a Medicare Part D plan or additional coverage for out-of-pocket costs through Medicare Supplement Insurance, or Medigap. Alternatively, beneficiaries may choose a private Medicare Advantage Plan that may also include vision, dental, hearing, and prescription drug coverage.
When assessing options, consider coverage and costs. Often people will change plans to save on premiums. The decision also depends on your care needs, including the doctors or care networks you prefer, prescriptions you want covered, and the pharmacy where you typically have those filled.
For the best advice, consult trusted sources such as Medicare.gov, 1-800-MEDICARE, or the State Health Insurance Assistance Program (SHIP) via ShipHelp.org. By making an appointment with your local SHIP office, you can have a counselor help identify the best plans for you for the coming year.
During open enrollment season, be wary of misleading marketing practices and double-check whether your personal providers and prescriptions may be covered under a certain plan. It’s important to do your own research and not solely rely on advertisements or sales brochures.
Act sooner rather than later during Medicare’s enrollment period, which began Oct. 15 and lasts until Dec. 7. Missing the deadline could mean waiting until the next open enrollment and potentially missing a chance to save money or get better healthcare.
In conclusion, Medicare open enrollment is a crucial time for beneficiaries to review and potentially change their health and prescription drug coverage. By taking the time to assess options and seek advice from trusted sources, beneficiaries can ensure they have the best coverage for their needs in the coming year.
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