The Medicare open enrollment period, which runs from October 15 to December 7, is already in full swing for millions of retirees, but many find the procedure difficult. According to a July 2022 research from health care consulting company Sage Growth Partners, many consumers are confused about the differences between Original Medicare and Medicare Advantage, many are overrun with Medicare advertising, and barely 4 in 10 people check their plan alternatives each year.
Due to this, you may miss the Medicare open enrollment period and fail to compare your Medicare Part D prescription drug coverage to other available options or verify that your providers are in-network for the upcoming plan year.
The following are some typical Medicare open enrollment errors:
1. NOT CHECKING YOUR DOCTORS FOR 2023
If you have a Medicare Advantage plan, you typically have to go to a doctor who is in the network of that plan. The network of a plan may change at any time. Check to see if your preferred healthcare providers are still covered by the plan in 2023 before deciding to stay with it.
Since websites and provider directories aren’t always up to date, you might need to do some research.
According to DeMikel Shankle, president of Abby’s Consulting Services, “I was recently at a customer, and (the plan) indicated their doctor wasn’t in-network, and it took us calling the provider and digging up a separate site on the network side.” The best course of action, in my opinion, is to just confirm with the doctor’s office by calling.
2. NOT COMPARING PRESCRIPTION DRUG PLANS
Your prescription drug coverage is provided by a private insurance company, regardless of whether you have Original Medicare or Medicare Advantage, and it may alter what it covers each year. In 2023, the price of your typical prescription drug may increase, or an insurer may decide not to cover it at all. (Another plan might pay less to cover it.)
To see what plans Medicare.gov recommends for you, it pays to enter your prescription drug information. Pro tip: Your prescription history is already available when you log into your account at Medicare.gov.
“It makes it lot easier for them to buy for the next year,” says Katy Votava, president and CEO of Goodcare, a Medicare economics consulting company with a degree in health economics and nursing. “They don’t have to laboriously enter everything milligramme by milligramme and line by line.”
3. THINKING ALL DOCTORS WILL TAKE YOUR PPO PLAN
A health plan known as a preferred provider organisation, or PPO, allows its members to see doctors who are not in its network, usually at a higher cost. People occasionally believe they will be able to see any doctor they choose since they have a Medicare Advantage PPO. However, not all providers accept out-of-network coverage.
“Providers … can just refuse someone at the point of service if they don’t want to bill the plan,” DeMikel says.
As an illustration, the Florida-based Mayo Clinic is not in-network with the majority of Medicare Advantage plans and does not accept patients who have such coverage.
For full provider choice, choosing Original Medicare with Medicare Supplement Insurance, or Medigap, “is the most prudent solution,” DeMikel says.
4. BEING SWAYED BY THE SPLASHY ADS
Medicare advertisements abound during the open enrollment period for Medicare, and Medicare Advantage plans have enticing features like no premiums and limited coverage for hearing, dental, and vision care.
However, choosing your health insurance is about more than just the ancillary advantages. Votava claims that “most of the time, honestly, they don’t cover that much dental.” Be very careful because hearing aid coverage is likewise quite limited and should not be a reason to change your plan.
Making ensuring the plan covers your doctors and prescriptions for the upcoming year is more crucial, according to Votava.
5. WAITING TOO LONG TO ASK FOR HELP
The final day of Medicare open enrollment is December 7; however, you shouldn’t wait until that day or even that week to begin your investigation. Programs like the State Health Insurance Assistance Program, or SHIP, might provide assistance if you have any questions. Although they are busy, counsellors in SHIP programmes can provide free advice with your Medicare options.
In certain regions of the nation, SHIP programmes are fully booked several weeks in advance. Votava advises, “Don’t wait if you need aid.”
You can find your local SHIP at shiphelp.org.
