It’s no surprise when the Medicare open enrollment, or the annual enrollment period (AEP), is upon us. It occurs every year from Oct. 15 through Dec. 7. But almost 70% of Medicare participants don’t take that time to double check whether another solution could better safeguard their health and financial well-being. If you’re among them, this may be the year to pay attention to your Medicare plan.
“Many people have many reasons to shop this year,” whether that’s due to changes in coverage, premiums, or health concerns, says Erin Bueltel, Wellabe’s Director of Product Solutions.
Consider the following top reasons seniors change insurance during AEP in case one or more of their reasons apply to you, too.
Medicare Advantage (Part C) plans are sold by private insurance companies, and it’s common for some Medicare Advantage plans to be discontinued. But Bueltel says changes to how Medicare Advantage carriers get reimbursed and the Inflation Reduction Act have led to increased activity this year. The act, designed to strengthen the Medicare prescription program for participants, has created limitations for insurers, leading them to discontinue some plans, while older adults find new plans or switch to original Medicare (Parts A and B).
Medicare Advantage plans may remove providers from their networks, even during the coverage year. This can limit access to physicians or result in unplanned expenses. To ensure better network stability, Bueltel says people may switch to original Medicare with a Medicare Supplement plan.
Despite the exit of some plans, many Medicare Advantage plan options still exist or will be introduced in 2025. These may offer expanded benefits, cost sharing, and different provider networks.
If they had a creditable drug plan during the initial enrollment period, they may have not needed a Medicare Part D prescription drug plan. But if they were considering Part D this year for its improvements, enrolling during AEP could help them to avoid a monthly penalty fee for enrolling at a later date.
Bueltel says premiums for Medicare Advantage or Medicare Supplement plans are based on the area where the policyholder lives, so a move could affect the cost. Also, being in a new location may open up new options for coverage to explore.
If someone develops a chronic condition or requires skilled care, they may qualify for a Medicare Advantage Special Needs Plan (SNP), depending on eligibility and availability in their geographic area.
With age comes more vulnerability to chronic health conditions, accidents, and other concerns. AEP is an appropriate time to see if original Medicare with a supplemental plan is better for this stage of life or if adding insurance, such as Hospital Indemnity or Short-term Care, can help minimize the impact a health emergency could have on finances.
“Your first step is to drown out the noise,” Bueltel says, "You’ll be seeing a lot of ads, getting a lot of mail, and hearing different messages, especially during this election year. It’s important to realize that Medicare plans are set for 2025, despite any proposals candidates are making for the future of health care and insurance.”
With a clear focus, you can then:
Know what your current Medicare Advantage or supplemental plan covers and your rates so that you’ll be able to compare those details to other solutions.
Do you have new health concerns that may require specialized care, surgery, or medications? What coverage does your current plan provide for those needs?
If you have Medicare Advantage and/or a Part D prescription plan, you should have received a Plan Annual Notice of Change (ANOC) in September. It details any changes to your coverage or rates for the new year. You may then use the official Medicare website to explore options and to compare costs and benefits.
When exploring your options, your health insurance agent is your best source of information versus a friend or neighbor who may have recommended their Medicare plan.
“You may need a doctor that’s not in that person’s network, or you may have a condition that requires specific coverage,” Bueltel explains.
A trusted agent can provide the personalized help you need to get the health insurance that’s right for you.
At Wellabe, we’re here to provide the information you need to be well prepared and protected. Let us help you successfully navigate this AEP.
Photo credit: iStock
Kelly Rayburn, AVP national sales and distribution at Wellabe, and Olga Villaverde, from Lifetime TV’s The Balancing Act, discuss the areas that primary health plans and Medicare may not cover and how you can protect yourself with supplemental plans.
More topics at thebalancingact.com
Call 866-739-8143 or click the button below to have an agent contact you to develop a personalized free quote for any of our insurance plans.
