Even Medicare beneficiaries happy with their plans should use this open enrollment season to shop around and review their current coverage.
Medicare’s annual open enrollment period begins October 15 and ends December 7. This is the time when beneficiaries can switch insurance plans, or at least review the other options available. They can also switch to Medicare Advantage during this time (they cannot make changes to current Medicare Advantage plans – i.e. a separate enrollment period at the start of each year).
But not everyone takes advantage of this time to make a change. More than seven in 10 Medicare beneficiaries didn’t even compare plans during this time in 2018, according to the Kaiser Family Foundation, a health policy-focused nonprofit group. Often that’s because making the switch — or just reviewing options — can be overwhelming, said Dave Francis, CEO and co-founder of Healthpilot, a company whose services include automated, personalized insurance plan recommendations. -sickness.
“The proliferation of plans has created an increasingly large and complex set of decisions,” Francis said. “It is impossible for an expert to manage without the help of sophisticated tools.”
Still, avoiding the task can be expensive — some Americans might save more than $1,000 in some cases if they were enrolled in the right plan, Francis said.
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Changing plans isn’t necessary, but reviewing current coverage should be. The plans change every year, even for beneficiaries who remain with the same as the previous year. People can receive information regarding these changes to their plans by mail or online if they’ve signed up for these notifications, and they’re usually lengthy documents, said Ann Kayrish, senior Medicare program manager at the National Council on Aging.
Coverage changes can include drug alternatives, such as a cheaper drug instead of the prescription the patient has become accustomed to, or a doctor dropping out of the network. The copays might also change. “It’s the kind of stuff you need to make sure you revise every year,” Kayrish said.
The Biden administration’s Inflation Reduction Act, signed into law earlier this year, included provisions for health insurance — some of which will go into effect as early as the new year. These updates include an insulin cap of $35 per month for patients, as well as making certain vaccines, such as shingles, free for recipients.
“If you need a vaccine, like shingles — last year over 2 million seniors got that vaccine — most people had to pay $100 for that vaccine. In some cases, $200 for that shot,” Biden said at a White House event in September to discuss the Cut Inflation Act. “You wonder how many seniors jumped that shot? For sick old people, it may be because it’s too expensive.
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Although the insulin cap will be enacted for all Medicare beneficiaries, not all insurance plans have the same types of insulin products – another reason beneficiaries should consider current and alternative options, Kayrish said.
Beneficiaries have several resources to compare their health insurance plans. Medicare.gov has a search tool, for example, that will explain coverage for 2022 and 2023 plans. BenefitsCheckUp is another National Council on Aging program that older Americans can use to find plans and benefits. Healthpilot’s platform also analyzes the health insurance plans available to a beneficiary following asking them which prescriptions or doctors they prefer. Individuals can also consult a broker who specializes in health insurance options.
When you’re considering switching, think regarding the medications you’re currently using — or might be using next year — as well as which doctors, pharmacies, hospitals, and other medical facilities you’d rather visit. If a medical procedure is scheduled for next year, check that your current or potentially new insurance policy will help you.
“Be sure to check your coverage and make sure you’re in a plan that covers everything you need,” Francis said. “If you haven’t checked recently, you may not be covered for what you think you are.”