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Medicare Open Enrollment Ends on Dec. 7

Six things to know about how to best review and change your health coverage

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If you are one of the nearly 66 million Americans who get health care through Medicare, you have until Thursday, Dec. 7 to review your options and make sure you have the medical coverage you need at the most affordable price. For most enrollees, the six-week open enrollment period between Oct. 15 and Dec. 7 is the prime opportunity to take stock of your coverage and, if necessary, make changes.

Here are six tips to help navigate this all-important annual open enrollment period.

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1. Don’t ignore open enrollment 

Too many people let open enrollment come and go without checking to make sure their current coverage will take care of their medical needs and that they are getting the best deal financially. According to KFF, the nonprofit organization that closely tracks Medicare, in 2020 just 3 in 10 Medicare beneficiaries surveyed reported that they had compared their current coverage with other plans offered in their area. 

2. Know what you can and can’t change

If you are on original Medicare, it’s easy to switch to a Medicare Advantage (MA) plan if you choose to do so. And if you already have an MA plan and want to switch to a different MA plan, that’s also not a problem. MA plans are the private insurance alternative to original Medicare.

But if you already have an MA plan and want to switch to original Medicare, you likely will have difficulty getting an affordable supplemental — or Medigap — plan to take care of some of your out-of-pocket costs.

Why? Once you have gotten beyond your seven-month initial enrollment period, which straddles your 65th birthday, Medigap insurers in most states are allowed to charge you high premiums or even refuse to offer you a policy, especially if you have any preexisting conditions. So, check with your state insurance department to see what its Medigap rules are or reach out to your local State Health Insurance Assistance Program (SHIP) for help. 

3. Look at all of your costs

There are several different out-of-pocket costs under Medicare. Depending on which option you have (original or Medicare Advantage) and whether you get your prescription drugs through a standalone Part D prescription drug plan or through your MA plan, you’ll need to check to see how your various costs are changing for 2024:

  • Part A (covers hospital, hospice and some home care): Most people don’t pay the Part A premium because they’ve paid enough in Medicare taxes through their working life. For those who haven’t paid enough in taxes, the full Part A premium will be  $505 in 2024, down $1 from $506 this year. There is also a Part A deductible for each hospital visit. That deductible will be $1,632 in 2024, an increase of $32 from 2023. If you’re on original Medicare, you’ll need to check whether your Medigap plan pays that deductible. Hospital charges under Medicare Advantage plans vary, so you’ll want to check with your plan if those charges are changing for 2024.
  • Part B (covers doctor visits and other outpatient services): All Medicare enrollees have to pay the monthly premium, which is $174.70 in 2024, up $9.80 from 2023. (If you are collecting Social Security retirement benefits, the Part B premium is deducted from your monthly benefit.) Original Medicare enrollees also pay the annual deductible ($240 in 2024) and then are subject to a 20 percent copay for doctor visits and other Part B services. Some Medigap plans pick up many of those costs. Premiums, deductibles and copays vary by Medicare Advantage plan, so be sure to check if your plan’s out-of-pocket costs are changing.
  • Part D (covers prescription drugs): Premiums, deductibles and copays vary by plan, so check what your current plan will be charging you each month in 2024. Premium changes will vary widely by Part D plan: Some plans could hike premiums significantly next year, while other plans may actually lower monthly charges.

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But that’s far from the whole story. The copay or coinsurance you have to pay for each prescription is as important as your premium, so check those out. Equally important is whether the medications your doctors have prescribed are covered under the plan you select. The government does set a maximum annual deductible for Part D plans. That will be $545 in 2024, although many plans have lower deductibles. If you have a Medicare Advantage plan, your prescription drug coverage is probably bundled together with your medical coverage. Check out your plan’s benefit details to review its prescription drug coverage.

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4. Check in with your doctors

As you weigh your options, talk to your doctors. If you’re on original Medicare, you’ll want to make sure your providers still participate in Medicare. The vast majority of doctors in the U.S. do, but it doesn’t hurt to check. If you have a Medicare Advantage plan, check with your physicians to make sure they are still in your plan’s network. If not, ask them what networks they do belong to. It can be expensive to go out-of-network if you have an MA plan.

If you’re having trouble finding an affordable Part D plan that covers the drugs your doctors have prescribed, check with them to see if there is an alternative medicine that is covered and for less money.

5. Don’t wait until the last minute

You may need some time to work through whether you want to make changes to your coverage. Take a look at the “Medicare and You” handbook that the Centers for Medicare & Medicaid Services publishes each year. The handbook is mailed to Medicare beneficiaries, or you can look at it online. You can also call the Medicare hot line (800-633-4227) or your local State Health Insurance Assistance (SHIP) program for help. But don’t drag your feet. The closer it gets to the end of open enrollment, the busier these folks get.

6. It’s not your last chance to make changes

If you don’t take advantage of the annual open enrollment period, Oct. 15 to Dec. 7, there are ways you can make changes at other times during the year. If your circumstances change — you lose your job-based health insurance or move to a state where your current plan doesn’t do business, for example — you can qualify for a special enrollment period. And if you are already enrolled in a Medicare Advantage plan, you can change plans or switch to original Medicare during the annual Medicare Advantage open enrollment period, from Jan. 1 to March 31.

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