Three Things You Need to Know About Medicare Open Enrollment

If you are one of the approximately 66 million Americans who receive health care via Medicare, it is time to check your options and ensure you have the medical coverage you require at the lowest possible cost. Most enrollees will use the six-week open enrollment period between Oct. 15 and Dec. 7 to assess their coverage and, if necessary, make changes.
Three Things You Need to Know About Medicare Open Enrollment

Beneficiaries have until October 15 to assess and adjust their health insurance coverage.

Here are six pointers to assist you navigate the crucial yearly open enrollment period.

1. Do not disregard open enrollment.

Too many consumers let open enrollment pass without checking to ensure that their existing coverage meets their medical needs and that they are getting the greatest financial deal. According to KFF, a nonprofit organization that regularly monitors Medicare, only three out of every ten Medicare enrollees asked in 2020 said they had compared their current coverage to other plans available in their area.

2. Understand what you can and cannot alter.

If you have original Medicare, you can easily transfer to a Medicare Advantage (MA) plan if you so desire. It's also not a problem if you already have an MA plan and wish to switch to a different MA plan. MA plans are a private insurance option to traditional Medicare.

If you already have an MA plan and wish to convert to original Medicare, you may have difficulties finding a cheap supplemental — or Medigap — plan to cover some of your out-of-pocket expenses.

Why? Once you have passed your seven-month first enrollment period, which coincides with your 65th birthday, most states enable Medigap insurers to charge you excessive premiums or even refuse to provide you a coverage, especially if you have any preexisting illnesses. So, check with your state insurance department to see what Medigap restrictions exist in your state, or contact your local State Health Insurance Assistance Program (SHIP) for assistance.

3. Examine all of your expenses.

Medicare covers a variety of out-of-pocket expenses. Depending on whether you have original Medicare or Medicare Advantage, and whether you acquire your prescription drugs through a separate Part D prescription drug plan or through your MA plan, you'll need to check to see how your various prices are increasing in 2024:

Part A (hospital, hospice, and some home care): Most people do not have to pay the Part A payment because they have paid enough Medicare taxes throughout their working lives.

The whole Part A premium for people who haven't paid enough taxes will be $505 in 2024, down $1 from $506 this year. Each hospital visit also has a Part A deductible. In 2024, the deductible will be $1,632, up $32 from 2023. If you have original Medicare, you should check to see if your Medigap plan covers the deductible. Hospital rates under Medicare Advantage plans vary, so check with your plan to see whether they are changing for 2024.

Part B (doctor visits and other outpatient services): All Medicare subscribers must pay a monthly premium of $174.70 in 2024, an increase of $9.80 from 2023. (The Part B payment is withheld from your monthly income if you are receiving Social Security retirement benefits.)

Original Medicare enrollees must additionally pay an annual deductible ($240 in 2024) and a 20% copay for medical visits and other Part B services. Many of these expenses are covered by Medigap insurance. Premiums, deductibles, and copays differ by Medicare Advantage plan, so check to see if your plan's out-of-pocket payments have changed.

Part D (prescription drugs): Because premiums, deductibles, and copays vary by plan, check to see what your current plan will charge you each month in 2024. Premium changes will vary greatly depending on the Part D plan: Some plans' rates may rise dramatically next year, while others may actually cut monthly charges.

But that's not the entire tale. The copay or coinsurance you must pay for each medication is just as significant as your premium, so keep that in mind. Equally crucial is whether the prescriptions prescribed by your doctors are covered by the plan you choose.

For Part D plans, the government does set a maximum annual deductible. In 2024, the deductible will be $545, while many plans have lower deductibles. Prescription drug coverage is most likely combined with your medical coverage if you have a Medicare Advantage plan. Examine the benefit details of your plan to see if it covers prescription drugs.