Before finalizing your Medicare coverage choices, it's essential to consider these key points:
The festive season is fast approaching, but summer has already bid adieu, leaving us in the midst of another thrilling period: Medicare's open enrollment period!
Between October 15 and December 7, individuals eligible for Medicare can switch from one plan to another. Before taking any action during the Medicare open enrollment, here are some crucial points to consider:
Medicare fundamentals
You can enroll in Medicare once you begin approaching your sixtieth birthday. Upon enrollment, you'll have the option of choosing between "original" Medicare, incorporating Part A (hospital coverage) and Part B (physician and medical insurance), or a Medicare Advantage plan, also known as Part C.
Individuals who opt for original Medicare often incorporate Part D prescription drug coverage and sometimes a "Medigap" supplemental coverage plan as well.
Choosing between original Medicare and Medicare Advantage plans
Both original Medicare and Medicare Advantage plans give their own set of advantages and disadvantages. For instance:
- Original Medicare gives you easy access to almost every American doctor, with you usually only paying 20% of the costs, with Medicare covering the remaining 80%. This seems beneficial, but paying just 20% can still leave you with a hefty bill. (Medigap plans can help cover these costs -- for a fee.)
- A Medicare Advantage plan limits your out-of-pocket costs and typically offers dental, vision, and hearing coverage as well. However, to enjoy these lower costs, you'll be restricted to using providers and facilities within the plan's network. Some plans boast excellent providers and facilities, while others may not offer the specific ones you prefer. Certain Medicare Advantage plans have faced criticism for denying specific treatments to members.
Choose carefully, and whichever type of Medicare you go with, make sure to sign up on time -- or else you risk incurring a hefty penalty.
Changing plans -- during the open enrollment period
Regardless of the Medicare plan you select, you're not obligated to stay with it forever. Here are nine essentials to remember:
- You're granted the opportunity to switch plans yearly during the Medicare open enrollment, which happens between October 15 and December 7. (Additional special enrollment periods are available for certain individuals under specific circumstances, such as those who move to a new region.)
- Different plans might be more suitable for you at different stages of your life, depending on what features you require and could use.
- Plans evolve over time, in terms of what they cover and what they charge. For example, original Medicare will not cover most telehealth visits starting in 2025. Keeping up with what your current plan covers and what other potential plans offer is essential.
- Your choices include switching from original Medicare to a Medicare Advantage plan, switching from a Medicare Advantage plan to original Medicare, switching from one Medicare Advantage plan to another, and/or switching Part D prescription plans.
- Remember that if you're married, you and your spouse might be better served by different plans based on your individual needs.
- Although you can make numerous changes during the open enrollment period, you cannot switch your Medigap supplemental plan.
- If you're switching from a Medicare Advantage plan to original Medicare, you may not be permitted to sign up for a Medigap supplemental plan -- or you might be charged substantially more for it than you would have been if you'd signed up for it initially.
- Thoroughly considering all the options available to you, even if you're content with your present plan, can be beneficial, as you might be pleasantly surprised by some other plan.
- You can research your options using Medicare's own plan finder. Also, remember that Medicare assigns star ratings to Medicare Advantage and Part D plans, so opting for plans with higher star ratings -- particularly five-star plans -- is worthwhile.
Conduct research and critical thinking during the annual Medicare enrollment period to identify if any changes could serve you better and potentially save you money.
During the Medicare open enrollment period, which is from October 15 to December 7, individuals eligible for Medicare can consider switching to a plan that better suits their needs for the upcoming year. As people approach retirement, it's essential to understand that their Medicare plan requirements might change, and they may benefit from evaluating different options to ensure they are making the best financial decision for their retirement.
