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Get ready for Medicare open enrollment

The Medicare Fall Open Enrollment 2023 season is here and that means your mailbox gets bombarded with advertisements. Every time you turn on the television you hear another commercial about Medicare plans. It is by far the most confusing time of year for most Medicare beneficiaries: October 15th – Dec. 7th.

WHAT SHOULD I DO DURING THE MEDICARE FALL OPEN ENROLLMENT?

Many beneficiaries know they need to be doing something during the Medicare Fall Open Enrollment each year, but they are not sure what. The constant radio and television ads cause people anxiety because they wonder if they should be making a change or doing SOMETHING.

WHAT IS THE MEDICARE FALL OPEN ENROLLMENT PERIOD?

Also called the Annual Election Period, the Medicare Fall OEP came about with the introduction of Medicare Part D in 2006. It is an 8-week period every fall during which Medicare beneficiaries can enroll in,change, or disenroll from their Medicare Advantage and/or Part D drug plans. Here’s why the period exists: Part D plans and Medicare Advantage plans get to re-file their benefits with Medicare each year. This means the benefits and premiums on your plan can change or go up. So, Medicare lets you have an election period each year to change your plan if you don’t like the changes to your existing coverage. In short: your Part D benefits change every year, so you get an election period to change your plan if you don’t like those benefit changes. Now, the good news is that you do NOT have to change your plan if you like your plan. However, you should review your current plan’s changes and consider “shopping” just to make sure you get the best coverage for your money.

HOW DO I KNOW IF I NEED TO MAKE CHANGES TO MY PLAN?

The first day you can apply for a new Part D plan whether you get your Part D as a stand-alone plan or within a Medicare Advantage Plan is October 15th. Your new plan will become effective January 1st, 2023. Your Medicare Advantage or Part D Insurance plan provider will send you a document in September called the Annual Notice of Change. Take 15 minutes to sit down and review this document. It will tell you if the premium is changing, and if your copays, drug formulary or pharmacy networks are changing.

The Annual Notice of Change lists the plan’s changes side-by-side from 2022 to 2023.

WHAT CHANGES CAN I MAKE DURING MEDICARE OPEN ENROLLMENT 2023?

Your choices for plan changes during the Medicare OEP?

Do nothing and your current Medicare coverage will automatically renew in 2023

Enroll in, leave, or change your Medicare Part D drug plan

Switch from Traditional Medicare (red,white & blue card) to a Medicare Advantage plan

Switch from a Medicare Advantage plan back to Traditional Medicare (maybe with a supplement plan or medigap plan).

Change from one Medicare Advantage Plan to another

Keep in mind that Part D drug plans have no health questions. You can change to any other plan as long as you have either Medicare A and/or B and you live in the plan’s service area.

GOOD REASONS TO CHANGE YOUR PLAN

You may be wondering: what would be a good reason to change your Part D plan or Medicare Advantage plan for 2023? Here are some of the most common reasons that plans change during Medicare Open Enrollment:

Your plan is dropping one of your important medications next year. Your Annual Notice of Change letter will specifically list any changes to its drug formulary for next year. The plan must disclose if they are dropping any medications. They must also tell you if a medication is moving to a more expensive tier for next year. If you take a brand name medication now that won’t be covered the next year, you may want to change during the OEP to another drug plan that will.

Your Medicare Advantage plan is dropping your doctor from its network. Unlike Medigap or supplement plans, Medicare Advantage plans have a network of doctors. If one of your doctors is leaving the plan’s network, you can use the Medicare OEP to switch to another plan that your doctor still participates in.

Your plan has a drastic increase in premium. Please note that the key word here is “drastic.” Inflation happens to medical insurance plans just like it does to auto insurance plans. If your auto insurance goes up $3/month next year, would you go to the hassle of changing it? Probably not. Likewise, if the only thing changing on your drug plan is a small increase in premium, you don’t have to switch. But if your drug plan goes up $20/month, you might want to look to see if any other plan is cost effective.

Review the Annual Notice of Change. See if there are changes that make you want to shop around. This is your chance to look at other plans to compare them to see where you can get the best coverage for what your heath care needs are!

Medicare.gov is a website that allows individuals to set up their own account and review plans through-out the year, but especially during Open Enrollment. If you would like help with looking over your Medicare plan options, you may contact the Chautauqua County Office for Aging Services’ NY Connects Helpline at: 716.753.4582 and ask to meet with our health insurance counselor who can offer an unbiased review of all the plans available for 2023. Don’t wait to make your appointment, Open Enrollment is right around the corner!

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