The open enrollment period for Medicare will end soon. Those who want to join or change their Medicare plans for 2023 must do so before December 7.
Like many people, you waited until the last minute to buy your options. There are many reasons: inertia, fear, or feeling overwhelmed by too many choices. It’s not the kind of shopping people like to do, and it’s confusing. When the annual enrollment days are down and down, beneficiaries can make costly mistakes in their rush to choose a plan.
Here are some common open enrollment mistakes people make during the last few days and hours of Medicare open enrollment:
• Don’t check your doctors for 2023. If you have a Medicare Advantage plan, you generally must get health care from doctors in that plan’s network—and a plan’s network can change at any time. Before staying with the plan you’re in, make sure your preferred providers and hospitals are still in the plan’s network in 2023.
This may take some time as websites and supplier directories are not always up to date. Your doctor’s office staff rarely understands the differences between Medicare plans. The onus is on whether to accept the plan. If your doctor’s office participates in any Medicare Advantage plan, you must obtain the exact plan name(s) for the plan(s) in which they participate. Then double-check that information using your online Medicare Advantage plan directory.
Tip: Here’s an example of the wrong question to ask at your doctor’s office: “Do you take Blue Cross Blue Shield?” I’m only using Blue Cross Blue Shield (BCBS) as an example because they are a well-known brand. You can change it to any other insurance company name, but the result is the same. It is not specific enough. The doctor’s office may tell you that, yes, I am taking BCBS. The problem is that the employee may have meant that they accept BCBS Medigap plans, not BCBS Medicare Advantage plans, which are different. Alternatively, she may have meant that I take BCBS Medicare Advantage PPO, but that doesn’t mean I’m also in-network for the company’s Medicare HMO.
• Does not compare prescription drug plans. Whether you have Original Medicare or Medicare Advantage, your prescription drug coverage comes from a private insurance company and is very likely to change what it covers each year. Your regular prescription drug may cost more in 2023, or an insurer may not cover it. And in most cases, there is another plan that can also cover the drugs for less.
It’s worth logging your meds into Medicare.gov to see what plans they suggest. Tip: If you log into your account at Medicare.gov, your medication history is already there. This makes it much easier to buy plans rather than putting everything in line by line and milligram by milligram.
•Omission of Part D coverage without other coverage. I recommend that most of you enroll in Part D unless you have some other form of creditable drug coverage. Even if you don’t take any drugs, consider enrolling in the least expensive plan so you have coverage if and when you need it. You’ll also avoid the Part D late enrollment penalty.
•Thinking that all doctors will take your PPO plan. A preferred provider organization, or PPO plan, is a health plan that allows members to see out-of-network doctors, usually at a higher price. Access to a wide network of doctors, hospitals and other care providers at a negotiated rate is a significant benefit. With a PPO, you can pay a flat copay or a percentage (coinsurance) for things like doctor and hospital visits. However, not all doctors take every PPO plan. Providers can turn someone away at the point of service if they don’t want to bill the plan. Tip: For a complete choice of provider, choosing Original Medicare with Medicare supplemental insurance or Medigap is the most prudent solution.
• Being swayed by flashy advertisements and ancillary benefits. Medicare open enrollment season means Medicare ads galore, and Medicare Advantage plans have enticing things to offer, like no premiums and some coverage for hearing, dental, and vision care. But most of these ancillary benefits are relatively limited in nature. However, these are still “extras” that you don’t get with Original Medicare. Although they may sound appealing, remember that you should buy health insurance for reliable and solid coverage for serious health events or illnesses.
Tip: I don’t recommend choosing your health plan based solely on a dental benefit or gym membership.
• Wait too long to ask for help. Medicare open enrollment ends Dec. 7, but you don’t want to wait until the last day — or even the last week — to start researching. If you have questions, you can get help through programs like the State Health Insurance Assistance Program, or SHIP. Counselors at SHIP programs can provide free assistance with your Medicare options, but they are affected during the last days of open enrollment. If you need help, don’t wait. Alternatively, you can contact 1-800-MEDICARE (1-800-633-4227).
Of course, if you’re happy with your Medicare plan, you don’t need to take any action. However, do your due diligence and compare the options because you won’t know if there is a better option for you.
This year’s open enrollment is at least as important — perhaps more important than ever because of rising inflation. Don’t be put off by complacency. The best and most important thing you can do is focus on what needs to happen this year to ensure you are protected for 2023 and worry about whatever happens after 2023. Late.
(Joel Mekler is a Certified Senior Counselor. Send your Medicare questions to [email protected])