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Stay Informed and Save: Tips for a Successful Medicare and Drug Plan Open Enrollment Season

November 22, 2023

For the 66 million Americans enrolled in Medicare, the changing color of foliage in autumn doesn’t just announce the impending arrival of winter. It also heralds the arrival of the Medicare and Drug Plan Open Enrollment season.

The six-week season runs between Oct. 15 and Dec. 7 each year and is the time for Medicare enrollees to evaluate their coverage and make changes where necessary in preparation for the coming year. Making good use of the season is the best way to ensure your Medicare and drug plan matches your healthcare needs.


Unfortunately, wading through the intricacies of the Medicare plan can be challenging. That’s why we’ve put together this post for you. We’ll discuss important tips to save you money and headaches over the next year.


Understand What You Can and Can’t Change


During the open enrollment season, you can switch to a Medicare Advantage (MA) plan if you are on Original Medicare (and vice versa).

You can also switch from your current MA plan to a different one. For example, some people switch from an MA plan without prescription drug coverage to one with the coverage.


This window is also the time to join, leave, or switch to a Medicare Part D prescription drug plan or a new private insurer.

However, switching from an MA plan to Original Medicare may not be practical. 


Evaluate Any Changes to Your Current Plan


One of the first things you should do before or during the Medicare and Drug Plan Open Enrollment season is to find out what has changed with your existing coverage.


Most plans send an Annual Notice of Change (ANOC) around September.


When reviewing the changes, pay more attention to:


  • The list of drugs your plan will cover in the coming year
  • How much the drugs will cost
  • Your premium for the coming year
  • The percentage the plan will cover for various medical expenses you may incur


Check with Your Doctors to See What Plans They Will Accept in the Coming Year


Talk with your doctors to confirm that they will accept your existing plan in the new year. If they are dropping your plan, you need to check those they support to see if they are affordable for you and if you can switch to them.


If you’re on Part A or B Original Medicare, your doctors will likely support the plan. However, it’s still a good idea to check. You need to pay a premium for Part B Original Medicare, but it still doesn’t cover everything.


If you have a Medicare Advantage plan, you should check with your physicians to ensure they are still in your plan’s network. If they are no longer on the network, you need to find out which one they now belong to. Going out of network while on an MA plan is generally very expensive.


Compare Your Existing Plan with Your Health Needs


The best way to make the most of the Medicare and Drug Plan Open Enrollment season is to compare the existing plan to your current health needs. You also need to consider any future healthcare needs you’re aware of right now. For instance, if you have a renal disease, what happens in the event of kidney failure?


If you’ve received a recent diagnosis and the existing plan will no longer cover your medications, you may need to switch to a new one. When exploring Medicare plans to switch to during the enrollment season, be sure to check the following:


  • Coverage for prescription drugs. Medicare drug coverage will vary depending on your plan. Check out the plan’s provisions on what drugs are eligible. Are there any differences between generic and brand-name drugs?


  • Travel coverage. If you intend to travel abroad next year, you should confirm that your plan will provide coverage if you need health services. Original Medicare will not cover overseas treatment. You may need to take on supplemental insurance in this scenario.


  • Out-of-pocket costs. For any plans you’re considering, check the premiums, deductibles, copayments, and other payments not covered by Medicare.


Use Open Enrollment Resources


Whether you’re considering retaining your existing plan or thinking about switching to a new one, use the resources available to find the most cost-effective option. The State Health Insurance Assistance Program (SHIP) provides free counseling to all Medicare recipients.

The Senior Resource Center also provides guidance to Medicare enrollees looking to take advantage of the season.


Avoid Medicare Scams


Licensed or illegal Medicare agents publish numerous ads around this season. Avoid them. You should be wary of any Medicare personnel making unsolicited contact via call or text. 


You don’t want to fall for any scams that will leave you out of pocket or tie you to a health insurance program you don’t need.


Start Your Medicare and Drug Plan Open Enrollment Season Early


It’s easy to procrastinate when it comes to taking advantage of the open enrollment season. However, starting early allows you ample time to evaluate your options. Failure to take advantage of the window could mean waiting another year while enrolled in a suboptimal plan.


According to KFF, too many people fail to take advantage of the open enrollment. In 2020, only three in ten Medicare program enrollees reported comparing their current coverage with other plans before making a decision.


Make the Right Choice This Medicare and Drug Plan Open Enrollment Season 


With another Medicare and Drug Plan Open Enrollment season upon us, it’s another opportunity to ensure you have a cost-effective healthcare plan. Your choices within this window can have far-reaching effects on your healthcare and finances.Any mistakes may lead to a significant hole in your retirement plan.


At Senior Resource Center, we understand that finding the right coverage might feel overwhelming. Also, accepting assistance from insurers may feel like receiving a Trojan horse. Therefore, we offer consultation services and also provide the guidance you need to navigate the Medicare landscape.


Call Senior Resource Center in Austin, TX, at (512) 835-0963 to schedule a consultation today.

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If a public employee who did not pay into Social Security through their government job was married to someone who did, the GPO reduced the spouse’s Social Security benefits. This was particularly frustrating because it penalized spouses who were often not involved in the public sector but were impacted by the worker’s pension status. Both the WEP and GPO led to unfair reductions in benefits for hardworking public servants, including teachers, who spent years teaching and making a difference in their communities. For many, these provisions resulted in significantly lower Social Security benefits than they would have received otherwise. What’s Changed? The new federal changes that eliminate the WEP and GPO represent a massive shift toward equity for public sector employees, especially teachers, who were unjustly penalized for their service. These new changes will have the following impacts: 1. **Full Social Security Benefits** : Teachers who worked in government jobs and did not contribute to Social Security will now receive the full Social Security benefits they’ve earned through any private-sector work. The WEP penalty, which reduced these benefits, has been completely phased out. 2. **Fairer Spousal Benefits** : Spouses of public employees who didn’t pay into Social Security will no longer see their survivor or spousal benefits reduced under the GPO. This allows families to keep the benefits they deserve without being penalized for one spouse’s public-sector work. 3. **Increased Retirement Security** : Teachers and other public workers who were denied full Social Security benefits will now see an increase in their future benefits, providing greater financial security in retirement. Why This Matters for Teachers Teachers are often the backbone of our education system, and many of them work tirelessly to provide high-quality education to their students. For years, however, they faced a significant financial penalty through the WEP and GPO. These changes signal a recognition of the value of public education and the need to provide fair and equitable treatment to the people who educate and protect future generations. Not only does this change restore fairness, but it also acknowledges the importance of teaching as a long-term career, one that contributes immensely to society. By ensuring that teachers and other public employees can now access full Social Security benefits, these changes also ensure that educators have a more secure financial future. How Does This Impact Future Retirees? For teachers and public employees who are currently in the workforce, these changes will make a substantial difference in their retirement planning. With the elimination of the WEP and GPO, they can now plan with greater certainty about their future Social Security benefits. This new policy provides a level of financial stability and confidence that many workers have been lacking for decades. If you’re a teacher or public employee who has been impacted by the WEP or GPO in the past, you may want to consult with a financial advisor to better understand how these changes will affect your future benefits. It’s a new chapter for millions of Americans who have been long overdue for fair treatment. Conclusion Ending the Windfall Elimination Provision and Government Pension Offset is a long-overdue change that will bring significant relief to teachers and other public workers who have been unfairly penalized in the past. By ensuring these workers receive full Social Security benefits, the government is finally addressing decades of inequity. This is a win not only for teachers but for all public employees who contribute so much to our communities. For educators, the new rules offer a better path to a secure retirement, with a fairer calculation of their Social Security benefits. With these changes, we can begin to right the wrongs of the past and ensure that those who have dedicated their careers to public service can retire with the dignity and financial security they deserve. If you would like an analysis of your Social Security benefits, call us at 512-835-0963.
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