Shopping pays off during Medicare open enrollment

Medicare open enrollment takes place between Oct. 15 and Dec. 7. Open enrollment provides a dedicated time period in which those who are already enrolled in Medicare can add, cancel or switch plans. They are able to switch between Original Medicare and Medicare Advantage; change Medicare Advantage plans they have had; or add, cancel or change their Part D prescription drug plans.

Even though Medicare enrollees with Advantage or Part D plans can freely change plans during open enrollment, many hesitate to shop for better plans. This is despite the fact insurance experts warn existing policies’ terms can change, and that this window is the period in which they’re able to learn if they can obtain a better plan.

“We are creatures of habit,” says Lindsay Malzone, Medicare expert with Medina, Ohiobased Medigap.com. “For many Medicare beneficiaries, the process is so frustrating that they never want to change plans or look at trying to make a change once they choose a plan. Unfortunately, this puts some seniors at a disadvantage.

“Depending on their chosen path, they could be missing out on coverage that may fit their needs better, or even (on getting) the same coverage at a lower cost.”

Older adults spend more time shopping for a flat-screen TV than Medicare health plan options, adds Gil Bashe, chair, global health and purpose with New York City-based FINN Partners, and past participant in CMS (Centers for Medicare & Medicaid Services) Part D Information Working Group.

But when it comes to Medicare open enrollment, they need to be informed. Failing to look over their plans’ coverage benefits because they think it’s a hassle can be a life-threatening mistake, especially for people with chronic conditions, he says.

The Kaiser Family Foundation reported retirees benefitted from a record number of Advantage plans from which to choose in 2022. The number represented twice what was offered five years earlier. Experts report the addition of more plans, while providing more choice, can actually be a negative if their sheer numbers bring about confusion.

Gains achieved

Side-by-side comparisons can help older adults identify coverage for services across many plans, including traditional and Medicare Advantage plans, says Bethany Cissell, health care benefits expert at Belleville, Illinoisbased Allsup.

“Coverage terms may change, and care options may fluctuate with trends and networks,” she says. “Taking a close look at premiums, deductibles, co-insurance and other out-of-pocket costs can help you save money and give you more control over what’s important to you. For example, you may focus on lower premiums, or on the cost to treat specific medical conditions.”

In making these decisions, she added, a handy end-of-year spend report from your credit card company, or even receipts and bills you’ve kept, can greatly assist.

When shopping for new plans, look beyond cost and even beyond solely medically related considerations, recommends Dr. Darwin Hale, CEO and founder of Englewood, Florida-based Advocate Health Advisors.

Medicare plans often feature hundreds of benefits that fall into other categories, such as equipment, supplemental coverage for hearing aids and eyeglasses and health club memberships. Whether these categories are covered in a plan can be just as important a consideration as the premium amount paid each month. “Better coverage can mean receiving more for your health care dollar spent,” Hale says.

Comparing and contrasting Medicare Advantage plans also can spell the difference between gaining or failing to obtain still other extras, which can include a higher allowance for healthy food, utility assistance, more comprehensive dental coverage, cash cards and Medicare Part B premium deductions, Malzone says.

When it comes to Medicare Part D, shopping may reveal your medication co-insurance or co-pay is cheaper with a certain plan than another. Turning to Part B, you might find some plans that cover more for out-ofnetwork doctor visits compared with others. “Premiums vary by health plan organization and health plan types,” says Tramico Herman, founder and CEO of Suwanee, Georgia-based Zircon Consulting.

Help’s available

According to the Center for Retirement Research at Boston College, a number of resources stand ready to help you research your Medicare Advantage or Part D options.

• State counseling. Every state offers free counseling programs. Many of the volunteers who assist Medicare beneficiaries worked at one time as health care professionals themselves. In Illinois, the Senior Health Insurance Program (SHIP) can be accessed at: ilaging.illinois.gov/ship.html.

• Best drug plans. Older adults often commit costly errors when attempting to choose the right Plan D for their individual array of regularly-used medications. That is precisely why the Centers for Medicare and Medicaid Services offers a website to assist them in that often-complicated task. The same site can help oldsters locate Advantage plans. Explore your Medicare coverage options at medicare.gov. Use this same website to get updates about Medicare, obtain assistance with Medicare expenses and find and compare providers in your area.

• Online information. Starting with its “Frequently Asked Questions,” The Kaiser Family Foundation provides reliable information about Medicare at: kff.org/faqs/medicare-open-enrollment-faqs. The National Council on Aging offers information about Medigap. Go to ncoa. org and search for Medigap annual enrollment 2023.

Start early

If you are on Medicare Advantage, you are advised to review the new plans yearly, Malzone says. For those enrolled in Medicare Supplement plans, she urges checking every five years, or when you receive a higher-than-average rate increase.

“It’s best and fastest to work with a licensed insurance broker specializing in all Medicare options, (who) works with many insurance companies,” Malzone says.

Quipping “there is no Black Friday when it comes to preserving your health,” Bashe warns not to wait until Thanksgiving to start shopping. “My advice is to ask friends and family, or turn to community religious groups, leaders at your senior center or your financial consultant for advice,” he said.

“You’ll be thankful you started early.”