Millions of retirees are in the midst of open Medicare enrollment, which runs from Oct. 15 to Dec. 7, but many are finding the process difficult. Some don’t understand the difference between Original Medicare and Medicare Advantage, many are overwhelmed by Medicare advertising, and only 4 in 10 people review their plan options each year, according to a July 2022 report from health care consulting firm health Sage Growth Partners.
This leads to open Medicare enrollment lapses, including not confirming that your providers are in-network for the next plan year and not comparing your Medicare Part D prescription drug coverage with other options. available.
Guide to Medicare 2023: More guides and tips for Medicare beneficiaries
Here are some common Medicare open enrollment mistakes:
1. NOT CHECKING YOUR DOCTORS FOR 2023
If you have a Medicare Advantage plan, you generally need to get medical care from doctors within that plan’s network — and a plan’s network can change at any time. Before you decide to stick with the plan you’re in, make sure your preferred medical providers are still in the plan’s network in 2023.
This may require some legwork on your part, as websites and supplier directories are not always up to date.
“I was just at a client’s and (the map) said their doctor was out of network, and we had to call the provider and find a different site on the network side,” says Evan Tunis, president of Florida. Healthcare. Insurance. “The best thing I would advise is to call the doctor’s office and confirm with them.”
2. NOT COMPARING PRESCRIPTION DRUG PLANS
Whether you have Original Medicare or Medicare Advantage, your prescription drug coverage comes from a private insurance company, and that can change what it covers each year. Your usual prescription drugs may cost more in 2023, or an insurer may not cover them at all. (Another plan may also cover it for less.)
It pays to plug your medications into Medicare.gov to see what plans they suggest for you. Pro Tip: If you log into your account on Medicare.gov, your medication history is already there.
“It makes it a lot easier for them to shop for next year,” says Katy Votava, a PhD in health and nursing economics and president and founder of Goodcare, a consulting firm focused on Medicare economics. . “They don’t have to tediously put everything down line by line and milligram by milligram.”
3. THINKING THAT ALL DOCTORS WILL TAKE YOUR PPO PLAN
A Preferred Provider Organization Plan, or PPO, is a health plan that allows members to see out-of-network doctors, usually at a higher price. People sometimes think that because they have a Medicare Advantage PPO they will be able to see any doctor they want. But providers don’t always take out-of-network coverage.
“Providers… can just refuse someone at the point of service if they don’t want to charge for the plan,” Tunis says.
Case in point: Mayo Clinic in Florida is out-of-network with most Medicare Advantage plans and will not schedule appointments for members with out-of-network Medicare Advantage coverage.
For complete provider choice, choosing Original Medicare with Medicare Supplement Insurance, or Medigap, “is the most prudent option,” Tunis says.
4. GET SWALLOWED BY SPLASHY ADS
Medicare open enrollment season means Medicare ads galore, and Medicare Advantage plans have some enticing things to offer like no premiums and some coverage for hearing, dental, and vision care.
But buying your health coverage isn’t just about side benefits. “Most of the time, honestly…they don’t cover dental care as much,” Votava says. “Hearing aid coverage is also very limited, and that’s not the reason to change your plan, so be very careful.”
The most important thing, Votava says, is making sure the plan covers your doctors and prescriptions for the next year.
5. WAITING TOO LONG TO ASK FOR HELP
Open Medicare enrollment ends Dec. 7, but you don’t want to wait until the last day — or even the last week — to start your search. If you have questions, you can get help through programs like the State Health Insurance Assistance Program or SHIP. SHIP advisors may offer free assistance with your health insurance choices, but they’re busy.
SHIP programs in some parts of the country reserve several weeks. “If you need help, don’t wait,” says Votava.
You can find your local SHIP at shiphelp.org.
This article was provided to The Associated Press by personal finance site NerdWallet. Kate Ashford is a writer at NerdWallet. E-mail: kashford@nerdwallet.com. Twitter: @kateashford.
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