Medicare Open Enrollment: What Seniors and Their Families Need to Know

The pumpkins are out, the leaves are (not) changing, and there’s a slight chill in the morning air. All of this can only mean one thing: it’s time for Medicare Open Enrollment!

Medicare Open Enrollment for 2022 began October 15 and runs through December 7. The annual open enrollment period is designed to give Medicare recipients the chance to review their Medicare Advantage or supplement plans to ensure each plan best serves their individual needs.

A Brief Refresher on Medicare

Medicare has evolved since its inception in 1965. Modern Medicare is made up of four parts:

Part A covers hospitalization and hospice care. Part A does not cover “ordinary” medical expenses, however, so individuals without other insurance generally need to enroll in Medicare Part B, too.

Part B covers visits to your doctor, diagnostic testing, and other outpatient services. You might think of Part B as your general health insurance, as it covers more routine medical needs that Part A does not. Parts A and B are generally considered “Original Medicare.”

Part C permits Medicare Advantage Plans, which combine coverage found in Parts A and B. Medicare Advantage Plans are offered by private insurance companies and are intended to replace Medicare Parts A and B, though recipients are required to be enrolled in Parts A and B before enrolling in a Medicare Advantage Plan.

Part D permits plans to help pay for prescription drugs. Part D is optional, and plans are entered at the county level with private insurers.

These parts are designed to work together to cover most of the medical needs of seniors, but many recipients find it necessary to purchase supplemental plans to meet their specific financial or medical needs. Open Enrollment gives Medicare recipients the chance to re-evaluate their changing needs and select a plan that works best for them.

Making the Most of Open Enrollment

According to the results of a Kaiser Family Foundation study published October 13, 2021, a staggering 71% of Medicare beneficiaries surveyed did not compare plans during the 2018 open enrollment period, including those already enrolled in a Medicare Advantage plan. Overall, only 29% of all Medicare beneficiaries compared plans. The older or less wealthy a beneficiary is, the less likely they are to compare plans—precisely the individuals that might benefit most from doing so.

Choosing an appropriate Medicare Advantage or supplemental and prescription drug plans can provide beneficiaries with better coverage, lower premiums and, in some cases, both.

There are a few steps all Medicare beneficiaries should take to ensure that they make the most of the Open Enrollment period:

Review changes in policies. If you are currently enrolled in a Medicare Advantage or supplemental plan, you should be sure to review any upcoming changes to your policy that may take effect at the new year. Be sure to check your mail, email, and customer portal (if your client offers one) and keep an eye out for notices of changes to your policy.

Understand and assess your current coverage. Review your current policy benefits, keeping in mind any changes that may soon be made. Reflect on what your medical needs will be for the coming year, including prescriptions, and assess whether your current coverage adequately provides for your needs in a cost-effective manner. You may find that paying a little more up front in premium can save you costs in the long-run, or on the other hand, you might decide that the benefits of your plan far exceed your current and anticipated needs.

Preview supplemental health and drug plans for 2022. Take a look at the available plans for the upcoming year to see whether any better meet your specific needs. In addition to monthly rates, copays, or deductibles, be sure to consider whether your preferred doctor, health providers, and pharmacy are listed as “in-network” for that plan. You can review new plans online at medicare.gov or by phone at 1-800-MEDICARE, and consider consulting the 2022 Medicare & You handbook.

Florida’s SHINE Program

Need help reviewing your current plans and choosing a new one? Be sure to take advantage of Florida’s SHINE Program, a FREE service of the Florida Department of Elder Affairs and your local Area Agency on Aging.  SHINE (Serving Health Insurance Needs of Elders) provides health insurance information and unbiased, confidential counseling to Medicare beneficiaries, their families, and caregivers. The program’s website offers a number of free, downloadable resources to help beneficiaries understand Medicare, the enrollment process, and various coverage choices. To access the SHINE Program’s free counseling services in Polk County, call 1-800-336-2226 or visit their website to view the available counseling sites in Polk County.

Beware of Scams

The Medicare Open Enrollment period is rife with scams. Scammers often contact Medicare beneficiaries claiming to work on behalf of the federal government or Medicare Advantage plan providers. Never discuss private information with someone who calls you and claims to be from one of these organizations. If in doubt, hang up and call that organization directly (do not simply redial), or opt to provide that information via secure, official websites.