You have until December 7th to make changes to your Medicare coverage. During the Annual Enrollment Period, you can do things that you can’t do any other time of the year.
- Enroll in a Medicare Advantage plan if you have Original Medicare.
- Move from a Medicare Advantage Plan back to Original Medicare.
- Switch from one Medicare Advantage Plan to another.
- Switch from a Medicare Advantage Plan that doesn’t offer prescription drug coverage to a plan that offers drug coverage.
- Switch from a Medicare Advantage Plan that offers drug coverage to a plan that doesn’t offer drug coverage.
- Enroll in a Medicare Prescription Drug Plan (Part D).
- Switch from one Medicare Prescription Drug Plan to another.
Your new coverage will start January 1, 2023.
Do I have to do anything to stay enrolled in Original Medicare?
No. If you do nothing, you will keep your Origal Medicare (Parts A & B) coverage in 2023.
Do I have to do anything to keep my Medicare Advantage plan?
No, as long as your plan is still offered. If it isn’t, you will have to pick another plan.
If you’re enrolled in a Medicare Advantage health plan, you should have gotten an Annual Notice of Changes. This letter tells you how your plan coverage, costs, and service area will change in 2023. If you are okay with the changes, you don’t have to do anything to stay enrolled.
Medicare changes each year. So do you.
Here are 7 reasons why you should review your Medicare options each year:
1. Your health changed
You may go to the doctor more or less often, take different medicines, or need better access to healthcare services or specialists. You could find another plan that better meets your needs and/or lowers your costs.
You may also qualify for a Special Needs Plan (SNP), which is a Medicare Advantage plan for people:
- With specific diseases like cancer, chronic heart failure, or stroke
- Who are in a facility, like a nursing home, or who need nursing care at home
- Who are eligible for both Medicare and Medicaid.
Learn more about special needs plans, including what diseases are included and see if you are eligible to enroll.
2. Your income or asset level changed
There are programs that help pay premium, deductible, prescription drug, and other out-of- pocket costs for low-income people on Medicare. Income and asset limits apply.
Medicaid: a joint federal and state program that helps with medical costs
Medicare Savings Programs: a program that helps to pay premiums, deductibles, coinsurance, copayments, and prescription drug coverage costs
Program of All-inclusive Care for the Elderly (PACE): a Medicare/Medicaid program that helps people meet healthcare needs in the community.
Extra Help (Part D): a program that lowers Medicare prescription drug (Part D) costs.
Programs for people in U.S. territories: The U.S. territories also have programs that help people with limited income and resources pay their Medicare costs. If you live in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa, contact your State Medical Assistance (Medicaid) office for more information.
3. Your current Medicare Advantage or Part D plan may no longer be available
If your Medicare Advantage or Part D prescription plan is no longer offered in your area, you will have to pick a new plan.
4. New Medicare Advantage and Part D plans may be offered in your area
- A new Medicare Advantage plan may cost less or cover more services, like wellness a program, than the plan you have now.
- New Part D plans could have lower premiums or could offer better pricing on your medicines.
5. Your Medicare Advantage, Medicare Part D, or Medigap plan monthly premium increased
- If your monthly Medicare Advantage plan premium is going up, you should look for a similar plan at a lower cost.
- If your monthly Part D prescription drug premium is increasing, you should look for a similar plan at a lower cost. You should also compare plans if your prescription copayment will be higher.
- If you have Original Medicare with a Medigap policy, the monthly Medigap premium may be going up. A Medicare Advantage plan may cost less.
6. Your doctor or pharmacy may no longer be in the plan’s network
Networks change each year. You need to be sure that all the healthcare providers you see and the pharmacy you visit are in your plan’s 2023 network. If not, you will either need to change doctors or pharmacies, or pick a plan that includes your healthcare providers in its network.
7. Your medicine or dosages may no longer be on the plan’s formulary
A formulary is a list of generic and brand name prescription drugs covered by your Medicare Advantage or Part D plan. Formularies change each year.
Check what tier your drugs fall into. Each health plan splits drugs into groups, called tiers. The tier a drug is in depends on its type–generic, preferred brand, non-preferred brand, and specialty. The lower the tier, the lower the cost of the drug.
Not all plans have the same number of tiers and they don’t all put drugs into the same tiers. Plan ABC may list a medicine in tier 1, but Plan XYZ lists the same drug in tier 2, where it costs more.
- Your medicines are on the plan’s formulary
- You know what tiers they fall in
- Your dosages are still covered.
Now’s the time to review your options
You have until December 7th to review your current Medicare Advantage and Part D prescription drug plans. You can compare cost, services, and drugs across plans offered in your area. You can also compare quality and performance by looking at each plan’s star rating.
Pay attention to all the costs of your options. A plan with a lower monthly premium could end up costing you more if you visit the doctor often or take a lot of medicines. Add up your total out-of-pocket costs this year to get an idea of what your medical costs will be in 2023. Include premiums, deductibles, co-pays, and drug costs. If you have Original Medicare, add in the cost of your Medigap plan.
American Exchange can help you find the best plan for your needs
If you don’t want to sort through all the plans in your area or just want expert help, American Exchange is here for you. Our independent, licensed insurance benefits experts will listen to your needs, then compare available plans, prices, networks, formularies, and tiers. We will also let you know if you qualify for cost-saving programs. We do not work for an insurance company, so we compare all plans available in your area at no cost or obligation to you. Contact us today.
During the Medicare annual enrollment period, our agents are available to speak with you:
Monday through Friday from 8:00 a.m. to 8:00 p.m. Eastern Time
Saturday 8:00 a.m.to 5:00 p.m. Eastern Time
Sunday 12:00 p.m. to 5:00 pm. Eastern Time
Our office will be closed November 24-25, 2022 for Thanksgiving.
Medicare Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
American Exchange is a licensed health insurance broker. Robert Huffaker, NPN 13568432