Retirees can purchase health services during Medicare open enrollment. It’s a good time to review costs, experts say

Medicare open enrollment for 2025 will begin on Tuesday.

Beneficiaries have from Oct. 15 to Dec. 7 to review their Medicare coverage options and choose new plans for next year.

Experts say it’s an important opportunity that retirees shouldn’t ignore.

However, only 30% of Medicare beneficiaries review their options annually, according to research from KFF, a provider of health policy research.

“Each year, it makes sense to compare coverage options, because people’s needs change from year to year, and plans change,” said Tricia Neuman, executive director of Medicare KFF policy program.

“Making these comparisons can make a big difference in terms of safety and cost,” he said.

The new year will bring new changes to Medicare, which means beneficiaries may want to do some careful research during this open enrollment period.

“My best advice is to start early,” said Ryan Ramsey, associate director of health and benefits affairs at the National Council on Aging.

During Medicare open enrollment, retirees can choose new health plans and prescription drug plans.

They may switch from original Medicare, provided by the federal government, to privately managed Medicare Advantage plans. They can also switch from Medicare Advantage to original Medicare or change Medicare Advantage plans.

Original Medicare includes Medicare Parts A and B. Medicare Part A covers care provided by hospitals, skilled nursing facilities and hospice, as well as home health care. Medicare Part B covers physician services, outpatient care, medical equipment and preventive services.

Beneficiaries of original Medicare can choose to add drug coverage by signing up for a Medicare Part D plan, or additional coverage for out-of-pocket costs through Medicare supplement insurance, or Medigap.

Alternatively, beneficiaries can choose a private Medicare Advantage Plan, which offers Medicare Parts A and B, and may also include vision, dental, hearing and drug coverage.

In 2025, a $2,000 cap for Medicare Part D out-of-pocket costs will go into effect.

The change, which was part of the 2022 Tax Cuts Act, is “good news” for retirees with expensive prescription drugs to take, said Philip Moeller, author of “Get What’s Yours for Medicare: Increase Your Coverage, Reduce Your. Costs.”

However, insurance companies may try to pass on the higher Medicare Part D and other drug coverage costs they now face as a result of the changes, Moeller explained. That could come in the form of higher co-pays, more expensive coverage levels for certain drugs or lowering the use of some drugs altogether.

“This means that consumers should be really cautious about open enrollment,” Moeller said.

In particular, the Biden-Harris administration has moved to protect beneficiaries from large increases by raising the permitted increase in Part D premiums to $35 per month by 2025, KFF’s Neuman said.

Retirees should also be wary of switching to Medicare Advantage coverage, Moeller said.

In some cases, private entrepreneurs may cut projects or move to areas that are no longer attractive to their businesses. While retirees may want to look to Medicare Advantage plans for their prescription drug coverage, they should be aware of potential changes in those plans that affect the total costs they will pay, Moeller said. explained.

People with Medicare Advantage who want to switch to original Medicare should be aware that they may not be able to purchase a Medigap policy if they have a pre-existing condition, Neuman said.

In particular, four states have protections against that – Connecticut, Maine and Massachusetts and New York.

“In some areas, it may be more difficult for people to opt out of a Medicare Advantage plan and get a Medigap plan if they have a serious medical condition or even asthma, diabetes and other conditions. others,” Neuman said.

Experts say thorough research is the best way for retirees to estimate the costs they may face in their current plans or in changing affairs.

Individuals can use Medicare.gov to compare plans or contact Medicare by phone at 1-800-MEDICARE.

National Health Insurance Assistance Program, or SHIP, programs are also available in every state and offer free, in-depth, impartial counseling, according to Ramsey.

Start now, if possible, Ramsey said.

That extra time will allow you to compile your Medicare.gov log-in, prescription drug list and have more time to review plan comparison information and ask follow-up questions, he said. like that.

Importantly, any security changes don’t need to be rushed, Moeller said, and you should give yourself plenty of time to consider your security options.

“There’s no reason to rush to judgment,” Moeller said. “Even if you wait until December 7 to choose coverage for 2025 it will start on January 1 next year.”