Making the Most of This Year’s Medicare Enrollment Period

The Medicare Annual Election Period is your opportunity to select a plan for the following year. Since many Medicare Advantage plans will be making changes to their benefits and costs, it’s important not to miss out on this opportunity.

How Does Medicare Open Enrollment Work?

Every year, the Medicare open enrollment period (often called the Annual Election Period) starts on October 15 and ends on December 7. During this time, Medicare enrollees can choose a new Medicare plan, which will go into effect on January 1.

• If you’re enrolled in Original Medicare, with or without a Medigap Supplement plan, you can stay in Original Medicare and select a Medicare Part D prescription drug plan. Alternatively, you can leave Original Medicare and enroll in a Medicare Advantage plan.
• If you’re enrolled in Medicare Advantage, you can keep your plan or select a new Medicare Advantage plan. Alternatively, you can leave Medicare Advantage to go back to Original Medicare and select a Medicare Part D prescription drug plan.

Medicare Advantage plans are offered by private insurance companies. They combine Medicare Parts A and B into a single plan. Most Medicare Advantage plans also provide prescription drug coverage, and many offer additional benefits, such as dental, vision, and hearing. Original Medicare does not include prescription drug coverage or dental, vision, or hearing coverage.

What Doesn’t the Medicare Open Enrollment Allow?

The fall open enrollment period does not apply to Medicare Supplement Insurance Plans, also called Medigap. You receive a Medicare Supplement Open Enrollment Period when you turn 65 and enroll in Medicare Part B. If you try to apply for a plan after this, and you don’t qualify for a special enrollment period with supplement plan guaranteed approval, insurers may charge you more or deny you coverage, depending on your health.

The fall Medicare open enrollment period is for people who are currently enrolled in Medicare and want to switch plans for the upcoming year. If you are not currently enrolled in Medicare, you can sign up during your Initial Enrollment Period, which falls around your 65th birthday. If you miss this period, you can sign up during the General Enrollment Period (which runs from January to March every year) or see if you qualify for a Special Enrollment Period.

Medicare Plan Options: Costs

Most people do not pay a premium for Medicare Part A, but there is a premium for Part B. There is also a premium for Part D. If you sign up for Medicare Advantage, you will pay the Medicare Part B premium along with any premium your Medicare Advantage plan charges. Some Medicare Advantage plans have a $0 premium, but paying a higher premium may be worthwhile if the plan provides useful benefits.

According to Better Medicare Alliance, the nation-wide average Medicare Advantage premium for 2024 is $18.40, and approximately 75% of Medicare Advantage plans have a $0 premium. Overall, Medicare Advantage beneficiaries spend, on average, $2,541 less on out-of-pocket costs and premiums annually compared to people enrolled in Original Medicare.

When comparing plans, look at the total costs, including your expected copays. To gain an accurate idea of what you will pay, it’s useful to think about the prescriptions and healthcare you expect to need in the coming year.

Medicare Plan Options: Benefits

In addition to costs, it’s important to compare benefits.

• What providers are in the plan’s network? If you have preferred primary care providers or specialists, check to see if they’re in the network.
• Which prescriptions does the plan cover? Check the plan’s drug formulary to see if it covers your prescriptions and how much your out-of-pocket costs will be.
• What supplementary benefits does the plan offer? If you are interested in a particular benefit – such as vision care – find out if this is included.

According to KFF, Medicare enrollees had an average of 43 Medicare Advantage plans to choose from in 2024. Since there is a lot of variation between plans, it’s worth taking some time to understand your options.

What Should You Do If You Like Your Plan?

If you like your plan, you may want to keep it – assuming it’s not being discontinued. However, you should bear in mind that plans often change each year. It’s important to make sure you’re happy with any changes to your plan.

Every September, Medicare carriers send out the Annual Notice of Change, which lists any changes to your plan. For example, your plan might add benefits – or it might cut benefits. Your premium, copays, and deductibles may also change. Review changes carefully before making a final decision about your coverage.

Keep in mind that other plans will also experience changes. Some of these changes may make other plans better suited to your needs. It’s also possible that new plans will become available in your area. Therefore, even if you like your plan, it’s worth checking if there’s a plan you like even more. Take advantage of the fall open enrollment period to compare your options. Even if you end up sticking with your plan, you’ll have the peace of mind that you made the right decision.

Plans This Year May See More Changes Than Usual

Every year brings change, but the changes for plan year 2025 may be especially noticeable.

According to Fortune, Medicare insurers are dealing with a base payment cut along with higher-than-expected utilization rates. In other words, they’re receiving less money from the government and paying more in claims, which is leading to financial strain. As a result, many plans will likely cut benefits and raise prices.

Furthermore, Modern Healthcare says some health insurance companies are scaling back their Medicare Advantage plan offerings. Cigna, for example, is cutting some plans in certain states.

These changes are concerning for people who depend on Medicare for their healthcare. However, it’s still possible to find a plan that meets your needs – you may just need to put a little more time into the process.

• See how your plan is changing. Review your Annual Notice of Change carefully to see whether your costs or benefits are changing. If your insurer is not offering your plan for 2025, you’ll need to pick a new Medicare Advantage plan or switch back to Original Medicare and select a prescription drug plan.
• Determine which supplementary benefits matter most to you. If some of the plans in your area reduce the number of supplementary benefits they offer, you will need to prioritize those that make the biggest difference to your wellbeing and budget.
• Enlist the help of an agent. Finding the right coverage may be more challenging this year, but an agent can review your coverage needs and compare your plan options. Even if you’ve handled enrollment on your own in the past, you might welcome some assistance this year. By law, Medicare agents cannot charge you for their services.

Do you need help selecting a plan during the Medicare enrollment period? Altura Benefits can guide you through the process. Once you’ve enrolled in a plan, we’ll continue to provide you with support to help you navigate claims and ensure you’re satisfied with your plan. Learn more.