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Six Things to Know About Medicare Open Enrollment

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So, have you started shopping yet? Not holiday shopping – open enrollment shopping. Medicare open enrollment is entering week three, not too far from the halfway mark, so your window of opportunity to shop for the right health insurance and drug coverage for 2024 will begin closing soon. You have until December 7th to evaluate plans and select the one that’s right for you.

Here on the Blog, we recognize that millions of Americans are experiencing open enrollment for the first time. With that in mind, we turn to the trusted source for retirement-related information, AARP, where we discovered this helpful article on the basics of open enrollment.  Dena Bunis, reporter for AARP, wrote the article, which highlights six things you need to know to take advantage of this “shopping season.”

We think this is a generally helpful overview. We also feel the need to call special attention to Bunis’s fifth point: don’t procrastinate. The time to start the process is today.

Open Enrollment Potentially Affects 66 Million Americans

“If you are one of the nearly 66 million Americans who get health care through Medicare, it’s time to review your options and make sure you have the medical coverage you need at the most affordable price,” AARP’s Bunis writes. “For most enrollees, the six-week open enrollment period between October 15 and December 7 is the prime opportunity to take stock of your coverage and, if necessary, make changes.”

As we noted above, we’re already three weeks into a window that’s only open for about six and a half weeks. Here are the six critical things to know from the AARP article.

Open Enrollment Tip #1: Dont Ignore It 

“Too many people let open enrollment come and go without checking to make sure their current coverage will take care of their medical needs and that they are getting the best deal financially,” says Bunis, and we agree. Perhaps because folks are complacent or the process seems too daunting, the majority blow off open enrollment entirely – a mistake some research says can cost money and create major coverage headaches.

The AARP article puts this “ignorance-is-bliss” attitude into perspective. “According to KFF, the nonprofit organization that closely tracks Medicare, in 2020 just 3 in 10 Medicare beneficiaries surveyed reported that they had compared their current coverage with other plans offered in their area,” it states. That’s a pretty paltry statistic. 

(For another look at open enrollment, check out this Blog article from a few weeks ago.)

Open Enrollment Tip #2: Know What You Can and Cant Change

Knowing what’s possible during open enrollment is a good place to begin. “If you are on original Medicare,” says AARP, “it’s easy to switch to a Medicare Advantage (MA) plan if you choose to do so. And if you already have an MA plan and want to switch to a different MA plan, that’s also not a problem. MA plans are the private insurance alternative to original Medicare.”

(We delved into MA plans just last week here on the Blog.)

But, as the article points out, reversing the process can be a challenge. “If you already have an MA plan and want to switch to original Medicare, you likely will have difficulty getting an affordable supplemental — or Medigap — plan to take care of some of your out-of-pocket costs,” Bunis writes.

The reason reverting to Medigap is tough involves Medicare’s rules. When first eligible, you can purchase a Medigap plan without evidence of insurability. “Once you have gotten beyond your seven-month initial enrollment period, which straddles your 65th birthday, Medigap insurers in most states are allowed to charge you high premiums or even refuse to offer you a policy, especially if you have any preexisting conditions,” says the article. You need to check out your state’s coverage rules, or reach out to your local State Health Insurance Assistance Program (SHIP) for help. 

Open Enrollment Tip #3: Consider More Than Just Premiums

As the AARP article warns, don’t succumb to the false allure of low premiums when choosing coverage, because low-premium plans can end up costing you more. Medicare comes with a wide array of what are referred to as out-of-pocket costs – expenses you have to pay for. Some of those costs change from year to year, and different plans cover different costs.

“Depending on which option you have (original or Medicare Advantage) and whether you get your prescription drugs through a standalone Part D prescription drug plan or through your MA plan, you’ll need to check to see how your various costs are changing for 2024,” AARP suggests. Here’s their rundown:

  • Part A (covers hospital, hospice and some home care): Technically, Part A comes with a monthly premium, but most people don’t pay it due to the Medicare taxes paid during their working life. If you don’t have a qualifying work history, Part A can cost as much as $505 per month in 2024. Part A also comes with a $1,632 deductible in 2024 for each hospital visit. Many Medigap plans pay that deductible. Beyond that, your hospital charges under Medicare Advantage and Medigap plans will vary, so compare carefully.
  • Part B (covers doctor visits and other outpatient services): “All Medicare enrollees have to pay the monthly premium, which is $174.70 in 2024,” says AARP. That’s a $9.80 boost per month over 2023. The Part B premium usually is deducted from your Social Security benefit.  If you’re on original Medicare with no supplemental coverage, you’ll pay the annual deductible of $240 in 2024 plus a 20 percent copay for doctor visits and other Part B services. Again, many Medigap plans cover some or all of those costs, and Medicare Advantage plans offer different premiums, deductibles and copays entirely.
  • Part D (covers prescription drugs): “Premiums, deductibles and copays vary by plan, so check what your current plan will be charging you each month in 2024,” AARP advises. “Premium changes will vary widely by Part D plan: Some plans could hike premiums significantly next year, while other plans may actually lower monthly charges.”  (This recent Blog article deals specifically with Part D drug coverage.)

Remember, says Bunis, that the copay you’ll pay for each prescription is as important as your premium, so you’ll need to check those out. Also, check to ensure that your medications are covered under the plan you select. “The government does set a maximum annual deductible for Part D plans…[of] $545 in 2024,” says the article. Many Part D plans as well as Medicare Advantage plans can save you money on drugs if you compare carefully.

Open Enrollment Tip #4: Ask Your Doctor!

The old adage to “ask your doctor” applies here as well. “As you weigh your options, talk to your doctors,” Bunis writes. “If you’re on original Medicare, you’ll want to make sure your providers still participate in Medicare. The vast majority of doctors in the U.S. do, but it doesn’t hurt to check.”

Checking to make certain your doctor is “in network” is vital if you have a Medicare Advantage plan. Remember, networks can change from year to year. Medicare Advantage plans save money in part by limiting which doctors you can see. “Ask [your doctors] what networks they do belong to,” AARP warns. “It can be expensive to go out-of-network if you have an MA plan.”

Open Enrollment Tip #5: Don’t Procrastinate!

Shopping for something as complex and important as health coverage takes a while, so don’t put it off. “You may need some time to work through whether you want to make changes to your coverage,” says AARP. “Take a look at the “Medicare and You” handbook that the Centers for Medicare & Medicaid Services publishes each year. The handbook is mailed to Medicare beneficiaries, or you can look at it online.”

There’s also a Medicare hot line (800-633-4227) as well as local State Health Insurance Assistance (SHIP) program for help. “But don’t drag your feet,” says the article. “The closer it gets to the end of open enrollment, the busier these folks get.”

Open Enrollment Tip #6: Other Chances to Switch Coverage

With all the urgency about open enrollment, even if you miss it, you may have an out. “If you don’t take advantage of the annual open enrollment period, October 15 to December 7, there are ways you can make changes at other times during the year,” the AARP article states. “If your circumstances change — you lose your job-based health insurance or move to a state where your current plan doesn’t do business, for example — you can qualify for a special enrollment period.”

Finally, for those already in a Medicare Advantage plan, there’s another opportunity to switch to another MA plan – or back to original Medicare – during the annual Medicare Advantage open enrollment period, from January 1 to March 31. But remember, you may find it harder to qualify for Medigap coverage the longer you wait.

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(originally reported at

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