December 25, 2024

Confused about Medicare open enrollment? How to maximize your coverage.

Medicare #Medicare

Medicare’s annual enrollment period is officially live, and all beneficiaries should conduct a review of the benefits they have (and may need). 

Retirement Tip of the Week: If you’re covered under Medicare, take the time this enrollment period to conduct a comprehensive review of your coverage—including any expected medical procedures, prescriptions or specialist doctor visits for next year. There are plenty of resources to help. 

The annual open enrollment period began on Oct. 15 and ended on Dec. 7. 

There are so many factors to consider when picking a health plan, making the task overwhelming. Beneficiaries also have to do a bit of planning for the future when they’re looking through their options during the open enrollment period, since the changes they make now will go into effect at the beginning of the new year. A lack of preparation can cost beneficiaries hundreds, if not thousands, of dollars more than they may otherwise have to spend. 

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Still, the endeavor doesn’t have to be overly complicated or stressful—here are a few things to consider to maximize your coverage. 

First things first—do a review of the year 

Take a good look at what your current coverage includes, and what your health situation was like this year. How many doctor visits did you go to? Were there any specialists you would have liked to visit but were out of network? How much did you spend on medications and services? After finding the answers to those questions and more, see how your current plan stacked up to your needs. 

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UnitedHealthcare has an annual enrollment checklist individuals can use to ensure they’re getting the right coverage for themselves. It includes questions such as “has my health changed in the last year,” as well as identifying the benefits and changes happening to current plans (you may have to reach out to your plan provider to find this information out if you aren’t familiar with any updates). 

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Then look at what else is out there 

Medicare offers a comparison tool for plans, where beneficiaries can shop around more easily for the available coverage options in their area. Be very specific in your comparisons—for example, list out all the medications you currently take and any you expect to take next year, to make sure that they’re covered. Also check that your preferred doctors and pharmacy are still in network if you were to switch, or what specialists are available in your area. You may want to get a head start searching for specialists you think you may need to visit in the following year, and checking the reviews and background of these doctors. Be mindful of the costs associated with every plan, in the form of copays, premiums and deductibles. 

Don’t forget vision, hearing and dental—or any other supplemental plans you might want 

It’s about to get much easier finding hearing aids over-the-counter for people with mild hearing impairments, but for those with more serious conditions, don’t forget to keep vision, hearing and dental in mind when comparison shopping. These three areas of health are important for all Americans, though older individuals might find they need more doctor visits and help in these arenas. Try to estimate what your out-of-pocket costs will be next year. 

It’s during this analysis beneficiaries may realize they want more coverage, such as in the form of Medigap, which is a Medicare supplemental plan, or Medicare Advantage, which is government-approved insurance plans private companies offer. The annual enrollment period between October and December allows individuals to switch from Original Medicare, which covers Part A for hospital insurance and Part B for medical services, to Medicare Advantage.

Know the resources available 

Beneficiaries have numerous resources to find the best coverage for their personal circumstances. 

There are licensed Medicare advisers who can help make sense of the various plans available, though individuals who go this route should vet the company and professional before moving forward with any advice. 

The National Council on Aging has its BenefitsCheckUp program, which helps pair people with the right health and nutrition benefits. 

Benefit counseling is also available through State Health Insurance Assistance Programs (called SHIP). 

And Medicare already released its handbook, “Medicare and You” for 2023. 

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