Tis the season… No, even though Christmas decorations are crowding out Halloween on store shelves, it is not quite time for the winter holidays. However, if you are 65 or over, it is the season of shopping! The Medicare Open Enrollment season is upon us and will last from Oct. 15 to Dec. 7, 2024.
Now is the time to assess your current coverage and shop around for perhaps a better deal or a plan more suitable to your current health needs. Here are 14 tips for getting the best coverage and care from the Medicare Open Enrollment Period:
1. Know the Open Enrollment Rules
Medicare’s open enrollment is a time period every year when you can:
- Change from Medicare Parts A & B (Original Medicare) to a Part C (private Medicare Advantage) plan
- Change from Medicare Advantage back to Original Medicare
- Join, drop or switch a Part D prescription drug plan
- Switch Medicare Advantage plans
You are never locked into your Medicare coverage for more than a year and it is important to assess annually for better insurance at a lower cost.
2. Find Out How Your Existing Plan Has Changed
Not everyone knows this, but Medicare plans can – and do – change. So, the first step is to find out what is new with your existing coverage.
If there are changes, your plan should have sent you a “Plan Annual Notice of Change” (ANOC) last September. If you think you missed it, call your insurer and ask for the “annual notice of change.”
Pay particular attention to:
- The list of drugs that the plan will cover in the next year
- How much those drugs will cost
- What the premium will be in 2025
- What percentage that the plan will pay for different types of medical expenses
3. Find Out What Plans Your Preferred Doctors Will Be Accepting in 2025
You may want to call your doctors’ offices and ask to speak with the billing department. They should be able to tell you which plans they will be accepted in 2025. If they are dropping your existing plan, then you will want to see if any of the other plans are affordable for you.
4. Assess If Your Existing Plan Is Still a Good Match for Your Health Needs
Once you know what your existing Medicare Supplemental plan will cover in 2025, you should compare how well that matches your current and anticipated needs.
Will your existing plan still cover the medications you take? Has your health changed and do you now have different needs?
5. Understand New Drug Plans (and Impact on Other Coverage)
For the first time, out-of-pocket prescription drug costs will be capped annually at $2,000, and all enrollees will have the option to pay those costs in the form of capped monthly installment payments instead of all at once at the pharmacy.
This is generally good news. However, insurers are tweaking their coverage which could result in fewer benefits on some plans. Again, be sure to look carefully at any changes to your current coverage.
6. Compare Your Existing Plan to Alternatives
Even if your existing plan works well for you, you should still shop around to see if there is a more cost-effective option.
You can contact your State Health Insurance Assistance Program (SHIP). SHIP (sometimes called by another name) provides free counseling to any Medicare recipient to help people choose a Medicare plan.
You can contact Medicare at 1-800-MEDICARE or Medicare.gov. They have a Medicare plan comparison tool that may be helpful.
The Boldin Retirement Planner also enables you to estimate your lifetime medical costs for different coverage types, health conditions and premium levels.
7. Beware of Medicare Scams and Don’t Believe All the Ads You’ll See
It is illegal for any licensed Medicare agent to make unsolicited contact with you. So, if you get a call, text, or voicemail from someone offering Medicare services, it is a scam.
Do not give out any personal information.
Also, be wary of the barrage of advertising you will likely see during this period.
8. Check Out Ratings on Plans
Once you have identified a plan or plans that may be a good fit for your particular health needs, you can look up how well those plans rate.
Medicare.gov lets you research plan quality and performance ratings.
U.S. News and World Report is also a reliable source. They evaluate all insurance companies and the plans they offer in each state. See the Best Medicare Advantage Plans and the Best Medicare Part D Plans.
9. Cut Your Prescription Costs
Even with supplemental coverage, prescription co-pays can add up. To save money, discuss your concerns with your doctor. Ask if they will prescribe a less expensive alternative or a generic.
Whatever your doctor prescribes, shop around to fill your prescription. Filling the same prescription at Costco versus CVS could save a lot. Ordering a 90-day supply online may save you even more.
10. Use a Health Savings Account (HSA)
If you’re still working and are eligible to contribute to an HSA, take advantage of it. Your contributions are made pre-tax, the money in your account grows tax-free, and you can withdraw funds from the account at any time tax-free, as long as the money is used for qualified medical expenses.
Learn more about HSAs: What they are and why they are a compelling savings option.
11. Be Proactive to Stay Healthy
If you are in good health, you’ll spend less on retirement health care costs.
Medicare offers a wide range of immunizations, preventive screenings and well-being programs for free.
12. Make Sure Out of Pocket Medical Costs Are Factored into Your Overall Retirement Financial Plan
Out of pocket medical costs are one of the three biggest expenditures for most retirees. Studies have shown that the total out of pocket Medicare costs are higher than the total Social Security income for the average retiree. In other words, Social Security income does not even cover what most retirees will have to spend on their health.
So, it is important to make sure that your retirement finances are prepared for this major expense.
The Boldin Retirement Planner is an award-winning tool that can help you prepare. This easy-to-use tool offers very detailed and sophisticated calculations and includes retirement health care costs.
13. Get Help with Your Decisions
Getting the right coverage for you can feel overwhelming. And, a lot of the assistance you might get comes from the insurers themselves and it is normal to feel skeptical of their recommendations.
Work with a Fee-Only Advisor: Boldin Advisors offers consultations with a fee-only CERTIFIED FINANCIAL PLANNER™. They are experts in everything financial, and we can match you to someone who specializes in retirement medical costs. Book a FREE discovery session today.
Take a Class: Boldin offers over 32 different classes all available on demand with different live sessions throughout the month. In our In Depth Collection, one of the 24+ sessions covers “Medicare and Long Term Care Fundamentals.” Learn more about the Boldin Classroom.
14. Know About Your Disenrollment Period
From January 1 to March 31, 2025 you can switch Medicare Advantage plans or move back to Original Medicare if you change your mind after enrollment.