As Medicare open enrollment draws to a close for 2022, here’s our perennial reminder: Check your plan — don’t just automatically roll over what you had last year.
That goes for any Medicare choice you made: U.S. government Medicare vs. Medicare Advantage; Medicare Advantage vs. Medicare Advantage, if applicable; your Part D drug plan; and your Medigap supplemental plan, if applicable.
Medicare Advantage plans can change networks and premiums from year to year.
Medigap plans, also known as Medicare supplemental plans (Part F and Part g, for example) can change from year to year.
Part D drug plans can change from year to year.
What the deadlines mean
During open enrollment from Oct. 15 through Dec. 7, you can join, switch or drop a plan — applies only to Part D drug and Medicare and some Medicare Advantage plans. You can change your plan for coverage effective Jan. 1, 2023, if the insurer gets your decision (and usually your money) by Dec. 7.
You can, for example, switch from a Medicare Advantage Plan that doesn’t offer drug coverage to a Medicare Advantage Plan that offers drug coverage, join a Medicare Part D drug plan, or switch from one Part D plan to another.
If you’re in a Medicare Advantage plan run by private insurance, the open enrollment period runs from Jan. 1 through March 31. You can switch to a different plan, or switch to U.S. Government Medicare (limitations may apply).
You can apply for a different Medigap policy (Part F or Part G, for example) at any time during the year, but you might find yourself in an underwriting situation — with your health being checked — if you enroll outside of the standard end-of-year enrollment period.
The news has been full of warnings about Medicare Advantage recently. The open enrollment period is also a time for a lot of scammers to try to steal personal information or sign you up for something you don’t want. Be careful.
A checklist of Medicare renewal questions
Some handy reminders:
Check to see if your doctors are still in-network (for Medicare Advantage). A M.A. network chan change dramatically. Medicare Advantage plans are basically HMO’s (health maintenance organizations) that have a limited network. Medicare Advantage plans also typically require prior authorization, which can lead to long wait times. Government Medicare is not an HMO and requires much less by way of prior authorization.
Check to see if your deductible went up, especially for a Part D drug plan. My premium went up to $10.90 from $7.20, and the deductible went up to $505 from $480. Not a big deal for me, but worth knowing and comparing — maybe there’s another $7.20 plan out there?
Check to see if your medications remain on the formulary.
Check to see if your premiums changed.
Check to see if certain benefits remain on your plan if you care about them — for instance a free gym membership to certain gyms under Silver Sneakers — or if another plan has a benefit that yours does not.
Pay no attention to headline-grabbing advertising featuring, say, football stars. Look at the fine print on a policy. Compare notes with friends and neighbors.
Related: Our handbook on how to choose a Medicare plan.
Resources
We’ve said it before and we’ll say it again: If you’re thinking Medicare Advantage is a great deal, read the small print, kick the tires, ask advisers, and think twice. Or maybe three or four times. Details here in our handbook on how to choose a Medicare plan.
Your state or city should have a SHIP hotline, for free health benefits counseling for Medicare enrollees. Use it. Ours in New York City is great; one in our suburban Westchester locale did not return a call. Some states use a different name for this umbrella program; in New York it is HIICAP.
The Senior Medicare Patrol may be of assistance. From their website: “Senior Medicare Patrols (SMPs) empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse.”
Want to go deeper? There’s a book for that: “Get What’s Yours for Medicare,” by Philip Moeller. It’s part of a series including “Get What’s Yours for Social Security,” by Moeller, Laurence J. Kotlikoff and Paul Solman.
There’s a hotline at the Medicare Rights Center: Call (800)-333-4114.
Questions and answers on the Medicare site.
There’s a lot of data on the Medicare Plan Finder, the government website that posts prescription drug and Medicare Advantage plan offerings.
