Sticking with your Medicare plan this open enrollment season? You could pay a hefty price.

Sticking with your Medicare plan this open enrollment season? You could pay a hefty price.

October 10, 2022
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Even Medicare beneficiaries happy with their plans should take the opportunity this open enrollment season to comparison shop — and review their current coverage.

Medicare’s annual open enrollment period begins on Oct. 15 and ends on Dec. 7. This is the time when beneficiaries can switch their insurance plan, or at least review other options available.

But not everyone takes advantage of this time to make a switch. More than seven in 10 Medicare beneficiaries did not even compare plans during this period in 2018, according to the Kaiser Family Foundation, a nonprofit group focused on health policy. Many times, it’s because making the change — or just reviewing the options — can be overwhelming. Still, avoiding the task can be expensive — some Americans could save more than $1,000 in some cases, if they were signed up for the right plan. 

Switching plans isn’t necessary, but reviewing current coverage should be. Plans change every year, even for beneficiaries sticking with the same one as the year before. Individuals may receive information about these changes to their plans in the mail, or online if they’ve signed up for those notifications, and they’re usually lengthy documents.

Coverage changes may include alternatives to medications, such as a less expensive drug in lieu of the prescription the patient has become accustomed to, or a doctor dropping out of the network. Copays could also change. These are the kinds of things you need to make sure you’re reviewing each year.

The open enrollment period allows people to make changes to their current coverage, such as switching to Medicare Advantage from Original Medicare or adding Part D, which is for drug coverage. There is a separate Medicare Advantage Plan enrollment period at the beginning of each year for people to make additional changes, though they cannot switch from Original Medicare to Medicare Advantage during that period.

The Biden Administration’s Inflation Reduction Act signed into law earlier this year included provisions for Medicare — some of which will be effective as early as the new year. These updates include an insulin cap of $35 per month for patients, as well as making some vaccine shots, such as the one for shingles, free of charge for beneficiaries.

Although the insulin cap will be enacted for all Medicare beneficiaries, not all insurance plans have the same types of insulin products — another reason beneficiaries should review current and alternative options.

Beneficiaries have multiple resources available to them to comparison shop their Medicare plans. Medicare.gov has a search tool, for example, that will explain coverage for 2022 and 2023 plans. BenefitsCheckUp is another program, from the National Council on Aging, older Americans can use to find plans and benefits. Healthpilot’s platform also analyzes Medicare plans available to a beneficiary after asking them what prescriptions or doctors they prefer. Individuals can also consult with a broker who specializes in Medicare options.

When considering a switch, think about what medication you’re currently using — or may be using next year — as well as the doctors, pharmacies, hospitals and other medical facilities you’d prefer to visit. If a medical procedure is expected in the next year, check to see that your current or potentially new insurance policy will help.

Make sure that you check your coverage and make sure that you’re in a plan that covers everything you need. If you haven’t checked recently, you may not be covered for what you think you are.