Every year the Social Security Administration’s Medicare program provides an open enrollment period that gives beneficiaries a chance to review their current coverage and decide on what they need to change. That period is currently underway and will continue through Dec. 7, 2022.
Your main focus during open enrollment will be deciding which type of coverage best fits your current health needs and financial situation. Making the right choice could lead to hundreds of dollars in savings — but you’ll need to do your homework.
“Most people don’t pay much attention to the open enrollment period and that can come at a cost,” Tricia Neuman, senior vice president of the Kaiser Family Foundation and executive director of its Program on Medicare Policy, told the AARP in an interview.
The most popular option for seniors is Original Medicare, which includes the following, according to the SSA website:
- Medicare Part A (hospital insurance): This helps pay for inpatient care in a hospital or at a skilled nursing facility following a hospital stay. It also pays for certain home healthcare and hospice care services.
- Medicare Part B (medical insurance): This helps pay for services from doctors and other healthcare providers as well as outpatient care, home healthcare, durable medical equipment and certain preventive services.
Other parts of Medicare are run by private insurance companies that follow rules set by the Centers for Medicare & Medicaid Services. You might want to pursue these options if Original Medicare doesn’t cover enough of your healthcare needs. For example, under Part B you’re responsible for 20% of the cost of a doctor visit or lab test.
Here are other Medicare options to consider during open enrollment. Keep in mind that these might carry additional costs, though they could end up saving you money over the long term:
- Medigap: This is a supplemental insurance policy that helps pay Medicare out-of-pocket copayments, coinsurance and deductible expenses.
- Medicare Advantage (previously known as Part C). This includes all benefits and services covered under Part A and Part B (such as prescription drugs), along with additional benefits like vision, hearing and dental care. With MA, all are bundled together in a single plan.
- Medicare Part D (Medicare prescription drug coverage): This helps cover the cost of prescription drugs.
If you have a Medicare Advantage plan, you don’t necessarily have to make a move during the regular open enrollment period currently underway. There’s also a special open enrollment period for those who are already enrolled in MA plans. As the AARP noted, the special open enrollment period for MA runs from Jan. 1 through March 31 each year. During this period, you can switch from one MA plan to another or to original Medicare. Switching to original Medicare means you’ll also be able to get a stand-alone Part D prescription drug plan.
You also get a second chance to apply for Part B if you miss your initial enrollment period. A general enrollment period runs from Jan. 1 through March 31. Your coverage starts the first day of the month after you sign up.
In terms of the current open enrollment period, you will want to review a few things before making your final choices on or before Dec. 7.
For example, if you are considering switching from original Medicare to a Medicare Advantage plan, the AARP advises making sure that your healthcare providers are covered in the MA plan’s network. Also, keep in mind that some MA plans require referrals to specialists or require prior plan authorization for certain diagnostic tests and other services.
If you are switching back to Original Medicare from an MA plan, you might not be able to get Medigapthat helps you pay out-of-pocket costs under original Medicare. Even if you can get Medigap, it might be expensive.
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