Everyone knows that Medicare is a federal healthcare insurance plan for all U.S. citizens reaching 65 years of age (or otherwise qualified, for example, by disabilities), but actually it is a name for several healthcare plan options. You choose among these options for coverage when you initially enroll in Medicare. But every year, you have an opportunity to change your choices based on your experience and perhaps changing needs. That opportunity is called the "Medicare open enrollment period."
The next open enrollment period, for 2023, begins November 1, 2022.
The choices you make when enrolling as a Medicare beneficiary for the first time (enrollment often is automatic when you apply for your Social Security benefits), or after many years when you may wish to change your plan, are worth understanding. After all, this is your healthcare during years when it can count most!
Choosing between Original Medicare and Medicare Advantage
The tag, "Original Medicare," applies to when you first join the program. Original Medicare includes Medicare Part A, to cover your hospital care, and Part B, for to cover care by your physician and other out-of-hospital providers. But in addition to these basic Medicare coverages when you join, you have choices such as Part D for a Medicare drug plan.
At the time you enroll, you also can select Medicare Advantage, a Medicare-approved plan of a private company that offers an alternative to Original Medicare for your health and drug coverage. If you choose Medicare Advantage you will have to use doctors within that plan's network. But there may be lower out-of-pocket costs than Original Medicare. And there may be extra benefits such as coverage of vision, hearing, and dental services.
Look in a bit more detail at these two main forms in which to get Medicare services:
- Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
- You can join a separate Medicare drug plan to get Medicare drug coverage (Part D).
- You can use any doctor or hospital that takes Medicare, anywhere in the U.S.
- To help pay your out-of-pocket costs in Original Medicare (like your 20% coinsurance), you can also shop for and buy supplemental coverage.
Medicare Advantage (also known as Part C)
- Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These "bundled" plans include Part A, Part B, and usually Part D.
- Some plans may have lower out-of-pocket costs than Original Medicare.
- Plans may offer some extra benefits that Original Medicare doesn't cover—like vision, hearing, and dental services.
These are initial choices, but the important point to remember is that the Medicare program makes it possible for you to change your choices every year. This is the Medicare Open Enrollment Period, when you can change all your initial choices based on your experience and changing needs.
For more detailed information, please check this article "Medicare, We've All Heard of It But Where do I Start?"
The 2023 Open Enrollment Period begins November 1, 2022
The next open enrollment period, for 2023, begins November 1, 1022, in most states. This is the window during which all the choices you made during Initial Enrollment are open to you, again. Based upon your experience with your initial enrollment choices, your healthcare needs, and your financial situation, this is your chance to change your mind.
As a side note, be aware that if you miss an enrollment deadline in your state, it might be possible still to qualify for a Special Enrollment Period if you've experienced a certain life event:
- The loss of health insurance through a job.
- Household changes such as marriage, divorce, a death in the family, or having a baby.
- A change in your home address.
See a list of qualifying life events. You have 60 days to enroll in a plan, if you qualify for an SEP. But, if you miss that 60-day window, you will have to wait until the next open enrollment period.
The choice of new options under Medicare may seem a bit complicated. In a sense, they are. But you can ask how your plan compares with other options on these points:
- Is your doctor and your other healthcare providers in the plan network?
- Are your prescription drugs on the plan formulary?
- Are you okay with your costs, including premiums, deductibles, co-pays, and coinsurance?
- Do you need additional coverage for dental, vision, and hearing care?
- Are you okay with your plan's additional benefits such as fitness programs, mail-order pharmacy, nurse line, and other wellness services?
Let's start planning now for Open Enrollment 2023
Yes, that is a lot to think about, but you don't have to go it alone. My Eligibility Resource can help you understand your options during the coming Medicare Open Enrollment Period. Our program professionals understand all the choices that you face during the Open Enrollment Period and how important they are to your healthcare.
You can review your experience with your choices during Initial Enrollment recently or perhaps many years ago, and let's discuss how your needs and financial circumstances may have changed. Then, you can make an informed choice of the Medicare options right for you now.
You never have to go it alone when seeking a program to meet your needs. Find out how to move forward with My Eligibility Resource program professional. Just fill out our simple form to get in touch with the right program professional for your issue.
Reminder: the 2023 Open Enrollment Period begins November 1, 2022, in most states. During this period, you can explore other plan options. The new plan benefits you choose will be in effect for the rest of the year and until you make another change.
Check in with a program professional at My Eligibility Resources early to begin discussing how you can change your Medicare choices to meet your changing healthcare needs and your financial situation. We are here to provide information and guidance and there is no charge. Here is the form to fill out to get things started.