Medicare Open Enrollment Can Help You Reduce Healthcare Costs for 2024

Medicare beneficiaries have until December 7 to change their Medicare health and prescription drug coverage for the upcoming year through annual open enrollment.

This year, there’s even more reason to pay attention, as financial help for prescription drug coverage is set to expand starting Jan. 1, according to Meena Seshamani, director of the Center for Medicare at the Centers for Medicare and Medicaid Services.

“It’s important for people to check if they might be eligible for financial assistance to help them pay their premiums, help them pay their copays,” Seshamani said.

Starting in 2024, people facing high prescription drug costs will no longer have to pay anything out of pocket once they reach the catastrophic phase of their benefits, she noted, thanks to the new legislation on prescription drugs.

Notably, Medicare beneficiaries who currently take insulin do not have to pay more than $35 per month for covered prescriptions. They can also access recommended vaccines for free, Seshamani noted.

There are other reasons why Medicare beneficiaries should pay attention to the annual enrollment period this year.

“Medicare open enrollment is so important because options change every year, and people’s health needs and financial situations change every year,” Seshamani said.

For beneficiaries, it is an opportunity to save.

“You’re never locked up for more than 12 months,” said Darren Hotton, associate director for community health and benefits at the National Council on Aging, an advocacy group for older Americans.

Here are answers to some key questions to help you navigate Medicare Annual Open Enrollment this year.

Medicare open enrollment allows beneficiaries to search for health plans and prescription drug coverage that better meet their needs.

Notably, health and drug plans change every year, so experts say it’s wise to review your selections to see which plans match your needs in terms of cost and coverage, as well as which providers and pharmacies of the network.

Beneficiaries may have the option to switch from a federally administered Original Medicare plan to a privately administered Medicare Advantage plan, or vice versa. Alternatively, they can change Medicare Advantage plans, Hotton noted.

Original Medicare includes Parts A and B of Medicare. Medicare Part A covers care provided by hospitals, skilled nursing facilities, and hospices, as well as some home health care. Medicare Part B covers physician services, outpatient care, medical supplies, and preventive services.

Original Medicare beneficiaries can choose to add coverage for prescription drugs by enrolling in a Medicare Part D plan, or additional coverage for out-of-pocket costs through Medicare Supplement Insurance or Medigap.

Alternatively, beneficiaries can choose a private Medicare Advantage plan, which provides Medicare Parts A and B, and may also include vision, dental, hearing, and prescription drug coverage.

“You can never again go into Medicare and say, ‘I’m done. I pick something and I’m done,’ because that’s always the wrong thing to do,” Hotton said.

“You have to decide which option is best for you,” he said.

Start by asking yourself whether you want Medicare with supplemental Medicare coverage like your parents’, or whether you want coverage like what an employer might provide, Hotton said.

Much of the decision depends on coverage and costs. For example, according to Hotton, people often switch plans to save on premiums.

The decision also depends on what you personally need for care: the doctors or care networks you prefer, the prescriptions you want covered, and the pharmacy where you typically get them filled.

“Even if you’re happy with the plan you’re in, there might be a better option for you,” Seshamani said.

You may have new choices this year, she noted, especially as the new drug law takes effect. Additionally, you may be eligible for financial assistance.

“It’s very important that everyone evaluates their options every year because options change, your health may change and your financial situation may change,” Seshamani said.

To get the best advice, experts recommend consulting trusted sources.

Beneficiaries can consult the agency directly through Medicare.gov and 1-800-MEDICARE, Seshamani said.

There is also unbiased local help available through the State Health Insurance Assistance Program, or SHIP, through ShipHelp.org.

By making an appointment with your local SHIP office, you can ask an advisor to help you identify the best plans for you for the coming year, said Hotton, former SHIP director for Utah. This can be done in person, over the phone or virtually. The entire process can take just 30 to 40 minutes, he said.

Many advertisements appear during open enrollment season. Unfortunately, it can also include deceptive marketing practices, Seshamani said.

It’s helpful to check whether your personal providers and prescriptions may be covered under a certain plan, and how they compare to other offerings, through Medicare.gov or your local SHIP office through ShipHelp.org.

When shopping for Medicare coverage, it pays to make sure you’re getting the best advice.

Verify what advertisements or sales brochures tell you with your own research through Medicare or SHIP.

Also be wary of who you take advice from, Hotton said.

“What you don’t want to do is just jump into a Medicare Advantage plan because your friend says he likes it,” Hotton said.

It also helps to check whether the coverage you want is available more cheaply elsewhere, he said.

“You pay the premium, you want to make sure you have really good coverage,” Hotton said.

The Medicare enrollment period began October 15. Although open registration will last until December 7, it pays to act as soon as possible.

“People should not wait,” Seshamani said.

“If you miss the December 7 deadline, then you will have to wait until the next open enrollment and you may miss an opportunity to save money or get better health care for you,” a- she declared.