Understanding Medicare Open Enrollment: What You Need to Know
As we shift from summer to the holiday season, another important period is upon us: the Medicare open enrollment season. This crucial time runs from October 15 to December 7, giving eligible individuals a chance to switch their Medicare plans. Here’s what you should keep in mind before making decisions during this period.
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An Overview of Medicare
You can sign up for Medicare as you reach age 65. At that point, you will choose between “original” Medicare, which includes Part A (hospital coverage) and Part B (medical insurance), or a Medicare Advantage plan, also known as Part C.
If you choose original Medicare, you may also decide to add Part D for prescription drug coverage, along with a “Medigap” supplemental insurance plan to cover additional costs.
Original Medicare vs. Medicare Advantage Plans
Both options come with unique advantages and drawbacks. Here are key points to consider:
- Original Medicare allows you access to nearly every doctor across the U.S., typically covering 80% of costs while you handle the remaining 20%. However, that 20% can lead to high expenses if a significant bill arises. Medigap plans can help mitigate these costs, but they come at an additional expense.
- On the other hand, Medicare Advantage plans set a limit on your out-of-pocket expenses and may include additional benefits like dental, vision, and hearing coverage. However, you must use providers within the plan’s network, which may not offer your preferred professionals. Some Medicare Advantage plans have faced scrutiny for denying care, which is another factor to weigh in your decision.
Careful choice is crucial, as failing to enroll on time may result in hefty penalties.
Switching Plans During Open Enrollment
You’re not locked into your Medicare plan forever. During the open enrollment period, you can change your plan annually. Here are nine essential points to remember:
- Open enrollment lasts from October 15 to December 7. There are also special enrollment periods for specific situations, such as moving to a new area.
- Your healthcare needs may change over time, affecting which plan is best for you.
- Medicare plans can change annually in terms of coverage and costs. For example, beginning in 2025, original Medicare will stop covering most telehealth visits, which underscores the importance of staying informed about your current plan.
- You can switch between original Medicare and a Medicare Advantage plan, change from one Medicare Advantage plan to another, or modify your Part D prescription plan.
- If you’re married, evaluate plans for both you and your spouse independently, as different options may better suit your separate needs.
- Although you can make numerous changes during open enrollment, switching your Medigap supplemental plan is not allowed.
- If you move from a Medicare Advantage plan back to original Medicare, you may face restrictions or higher costs when applying for a Medigap plan.
- Even if you are satisfied with your current plan, it’s wise to explore alternatives; you might find a better fit.
- Utilize Medicare’s plan finder and look for star ratings for Medicare Advantage and Part D plans. Select plans with higher ratings, particularly those with five stars.
Take time to assess your options during this enrollment period; small changes could enhance your coverage and potentially save you money.
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