Medicare Open Enrollment: Be Prepared, This Year Could Be Different
Medicare’s annual Open Enrollment season is approaching. There are steps many beneficiaries should take before it arrives.
During Open Enrollment (Oct. 15 – Dec. 7 each year) current Medicare beneficiaries can review the plans available and make changes.
A beneficiary can switch from Medicare Advantage to original Medicare or the opposite. Or a beneficiary can move from one Part D prescription drug plan to another. Changes in Medicare Supplement plans can be made at any time, including during Open Enrollment. See the August 2024 issue of Retirement Watch for more details about changes allowed during Open Enrollment.
Changes made during Open Enrollment take effect the following Jan. 1.
For many beneficiaries, this year’s Open Enrollment might be different than in the recent past, as I’ve been warning for months.
Various changes in Medicare’s rules have pinched the cash flow of many Medicare Advantage plans.
When the details for 2025 are rolled out this October, many Advantage plans are likely to reveal higher costs and fewer benefits than in 2024.
People enrolled in Advantage plans in 2024 or considering them for 2025 should review plan details for 2025 when they become available. They should be prepared to consider options such as moving to a different Advantage plan or switching to original Medicare and adding Medicare Supplement and Part D policies.
Changes in Part D prescription drug plans also are likely. The government has touted how it is negotiating prices on select drugs and capped the amount Part D policyholders will have to pay for medications during the year.
But most of the costs of those and other policy changes will be paid by drug manufacturers and insurers. Insurers are likely to pass the costs on to policyholders as higher premiums, coinsurance and deductibles. They’re also likely to change some of the medications they cover and move medications to different tiers. The amount a policyholder pays out of pocket for a medication depends on the tier it is in.
There also are likely to be fewer Medicare Advantage and Part D plans available.
One way to be ready for Open Enrollment is to open an account on the Medicare.gov website.
An online Medicare account provides a summary of your current coverage. You also can enter your current prescriptions and pharmacies. That makes it easier to compare different plans, especially Part D policies, during Open Enrollment. The site’s plan comparison tool will have all your information and quickly show you’re likely to pay out-of-pocket expenses under different plans.
Another action is to become familiar with your state’s State Health Insurance Assistance Program (SHIP). This free service, open to all Medicare beneficiaries, provides trained volunteer counselors who help explain Medicare, discuss plan options, compare different plans and offer ways to reduce Medicare costs.
SHIP counselors work with beneficiaries or their families and caregivers, mostly in in-depth individual counseling sessions.
Each state establishes its own program, using federal funding, so program details vary from state to state. The programs generally are operated through a state’s Department on Aging or similar agency.
Another important action, if you haven’t taken it already, is to establish a relationship with a local insurance agent who specializes in Medicare.
The policies and plans available and their details vary, usually from county to county. You could review all the policies available and use Medicare’s online plan comparison tool to select your package of coverage.
Or you could work with an insurance agent who is familiar with all the plans available in your area, learns about your needs and preferences and recommends individual plans for you.
A good agent also can explain details about Medicare so that you’re clear about coverage, gaps in coverage and the benefits available to you.
The better agents will be very busy once Open Enrollment is here. It’s a good idea to establish relationships before they’re in high demand.
