Medicare open enrollment 2023
Plus valuable info about vaccinations and the Inflation Reduction Act
Open Enrollment 2023
One of Medicare’s open enrollment periods started on October 15 and runs through December 7. If you want new coverage to begin on January 1, 2024 you should be looking at this now.
But first we need to talk about whether or not open enrollment applies to you.
Do I Have to Do Anything During Open Enrollment
If you have traditional Medicare, you like it, and you don’t want to replace it with a private Medicare Advantage insurance policy you don’t have to do a thing. Ignore the TV commercials, the magazine ads, the online ads, and the email.
If you’re not happy with your current Medicare coverage for any reason, this is a time that you can make changes, including switching your Part D (prescription drug) stand-alone coverage. Part D coverage is usually folded into Medicare Advantage so stand-alone Part D is only available if you have traditional Medicare.
If you have private Medicare Advantage insurance and don’t know if you want to keep it, or you’re thinking about moving to traditonal Medicare, now is a good time to look at your options. You have from October 15, 2023 to December 7, 2023 to make a change and be covered on January 1, 2024.
But while you’re considering your options, please read The Big Mistakes People Make in Medicare—and How to Avoid Them in the Wall Street Journal for an excellent overview of the numerous pitfalls that can occur if you don’t do your research. In addition, Paula Span at the New York Times published this very useful guide. You should also take a look at these two articles:
Insurers Are Gaming Medicare — To The Tune Of $140 Billion
‘The Cash Monster Was Insatiable’: How Insurers Exploited Medicare for Billions
Medicare Initial Enrollment Period
One important point that I keep coming back to is the Medicare Initial Enrollment Period (IEP). This has nothing to do with Open Enrollment or Annual Enrollment. Your IEP is a date range set by Medicare and begins three months before your 65th birthday (on the first day of that month) and ends three months afterwards. For example, if your birthday is July 14 your IEP begins on April 1.
The IEP is the one and only time you can enroll in a private Medigap/Medicare Supplement insurance plan without answering questions about your health. If you miss this window and want to enroll later you may be refused coverage, have certain medical conditions excluded, or pay a much higher premium. It can be a tough decision as Medigap insurance isn’t cheap and your health at 65 probably won’t be the same at 75. Only four states, Connecticut, Massachusetts, Maine, and New York require insurance companies to issue Medigap coverage outside the IEP.
Your Own Research
Doing your research means making an honest assessment of your current health-care needs and trying to project your future needs. In our demographic that can be a frightening and daunting job, and none of us has a crystal ball with a view of the future. Unfortunately this uncertainty is how many of us fall prey to insurance salespeople who want us to buy private Medicare Advantage insurance; the stories of later regrets are legion.
Equally unfortunate is that traditional Medicare monthly premiums and annual copays are a financial hardship for so many Americans, especially those who rely on Social Security payments as their sole support. As a result, Medicare Advantage can seem much cheaper in the short-run. If you or someone you know falls into this category, there is help available.
Finding Help
Medicare can be difficult to understand and even more difficult to research based on individual needs, but there is unbiased, free help available.
The State Health Insurance Assistance Program (SHIP) provides free, one-on- one local help to Medicare beneficiaries, their caregivers, and their families. It also can help you find financial assistance for your medical needs.
The Medicare Rights Center, a staunch advocate for traditional Medicare and for expanding its existing benefits, also provides Medicare counseling through its national hotline.
Medicare Savings Programs (MSPs) is part of the Department of Health and Human Services (HHS) and helps more than 10 million people with coverage of Medicare premiums and, in most cases, other cost sharing.
Medicare Premium Increase
Medicare Part B premiums are increasing in 2024 to $174.70 per month, up from $164.90 2023. The Part B annual deductible is also increasing from $226 to $240. Part B premiums for people in high income brackets are income dependent. The good news is that we’re getting a 3.2% increase in Social Security benefits.
The Inflation Reduction Act
Thanks to the Inflation Reduction Act, the cost of insulin for Medicare beneficiaries is now capped at $35 per month. That’s a significant savings for many seniors.
Beginning October 15, 2023 many beneficiaries will pay less for prescription drugs. Any drug covered by Medicare Part B will have a lower coinsurance if the price has increased above the rate of inflation.
Beginning in January, 2024, Medicare Part D enrollees whose drug costs are above $8,000 a year will no longer have to pay any cost sharing. By 2025, this will move to a flat $2,000 annual cap on prescription drug expenses.
Recommended vaccines are now covered under Medicare at no cost to you. That means no out-of-pocket cost for vaccines to prevent shingles, tetanus, hepatitis, COVID, and flu. The pneumonia vaccine may be covered under some circumstances.
Starting now (October 2023) if a drug company raises the price of a Medicare Part D prescription drug by more than the rate of inflation, the manufacturer will have to pay the difference in price to Medicare.
Medicare in the News
Insurers Are Gaming Medicare — To The Tune Of $140 Billion
Medicare supplemental insurance pros and cons to know
She has Medicare and Medicaid. So why should it take 18 months to get a wheelchair?
Medicare Advantage ads will look different this fall
Cigna Group announces settlement with US on claims it overcharged Medicare Advantage program