Open Enrollment – Medicare

19 October 2022

Medicare offers an open enrollment at this time every year.  For 2022 the window is October 15 to December 7.  This is the opportunity for a good look at your current coverage and what you might want to do for the next year.  A study shows that 57% of Medicare beneficiaries don’t take the time to review or compare coverage options.  Here are some of the reasons you should consider a look at what you have and what is available.

The terms of Medicare’s benefits evolve year over year.  As regulatory issues, availability, and lobbying continue, retirees should expect changes.  As an example, the Inflation Reduction Act now caps insulin at $35 per month as well as extensions on vaccine coverage.  In addition, we should see changes in the amounts of prescription drugs over the next several years.

Lifestyles change.  Sometimes there are big changes like relocating to another state.  If you are over 72 years old, your retirement plan’s Required Minimum Distributions (RMD) can affect your Medicare rates.  There are a number of different types of plans, some that include vision and dental or a fitness plan.  You should decide on coverage options based on what you are considering for the near future or how you would like to enjoy your way of life.

It is a good idea to align your financial goals and expenses with the cost of healthcare both in terms of premiums as well as deductibles.  Changes in income, like from retirement account withdrawals or capital gains, can affect the amount of disposable cash you have available.

Medicare does not cover nursing home care.  It might be advisable to explore other long-term care options.

There are companies and individuals who are skilled at helping you find the best plan or combination for your needs.  They have access to the rates and coverage from a wide range of plans and supplements.  Check with your financial advisor to see if they offer that service or can recommend a reputable source.

Traditional Medicare coverage is offered through a private company that contracts with the government to provide Medicare Part A (hospital) and Medicare Part B (medical).

Many people who opt for the traditional coverage also contract for a supplemental coverage, commonly called Medigap.  Original Medicare does not cover all the costs and these supplements can cover copayments, coinsurance, and deductibles.  It is different from a Medicare Advantage program.  In fact it is illegal for someone to sell you a Medigap policy if you have a Medicare Advantage program unless you are switching back to traditional Medicare.  The Medigap premiums can increase as the individual ages.  In addition you can contract for Medicare Part D, a prescription drug plan.  Medigap still does not cover everything like long-term care, private nursing, vision, dental, and hearing aids.

Medicare Advantage are also known as Part C or MA Plans.  Most include drug coverage.  Generally you will need to use providers that are contracted with the Plan or in their network.  They are similar to HMO, PPO, Private Fee-for-Service (PFFS) or Special Needs (SNP).

In addition, there are veterans plans, Program of All-inclusive Care for the Elderly (PACE), and demonstration or pilot programs, also called research studies.

Take advantage of the experts who will help you through the maze of Medicare coverage and who can direct you to plans that will be of most benefit to you.

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