Medicare Open Enrollment: 12 Tips to Get Great Coverage

Editor's Note: This story originally appeared on NewRetirement.

Tis the season … No, even though Christmas decorations are crowding out Halloween on store shelves, it is not quite time for the winter holidays.

However, if you are 65 or over, it is the season of a special kind of shopping! The Medicare Open Enrollment season is upon us and will last from Oct. 15 to Dec. 7.

Now is the time to assess your current coverage and shop around for perhaps a better deal or a plan more suitable to your current health needs.

Here are tips for getting the best coverage and care from the Medicare open enrollment period.

1. Know the Open Enrollment Rules

Medicare’s open enrollment is a time period every year when you can:

• Switch from original Medicare to Medicare Advantage (or vice versa)
• Change your Medicare Advantage plan
• Join (or switch to a different) Medicare prescription drug plan

You are never locked into your Medicare coverage for more than a year, and it is important to assess annually for better insurance at a lower cost.

2. Find Out How Your Existing Plan Has Changed

Not everyone knows this, but Medicare plans can — and do — change. So, the first step is to find out what is new with your existing coverage.

If there are changes, your plan should have sent you a “Plan Annual Notice of Change” (ANOC) last September. If you think you missed it, call your insurer and ask for the “annual notice of change.”

Pay particular attention to:

• The list of drugs that the plan will cover in the next year
• How much those drugs will cost
• What the premium will be in 2024
• What percentage the plan will pay for different types of medical expenses

3. Find Out What Plans Your Preferred Doctors Will Be Accepting in 2024

You may want to call your doctors’ offices and ask to speak with the billing department. They should be able to tell you which plans they will be accepted in 2024.

If they are dropping your existing plan, then you will want to see if any of the other plans are affordable for you.

4. Assess If Your Existing Plan Is Still a Good Match for Your Health Needs

Once you know what your existing Medicare supplemental plan will cover in 2024, you should compare how well that matches your current and anticipated needs.

Will your existing plan still cover the medications you take? Has your health changed and do you now have different needs?

5. New for 2024

While the specifics of your individual plan may change, here are some of the headlines for 2024.

Part B premiums and deductibles are increasing for 2024. In 2024, the standard Medicare Part B monthly premium will be $174.70. This reflects a 6% increase from 2023. That’s not the only financial impact on the way for Medicare Part B members, though. The annual deductible for Part B will also increase by $14 to $240 next year.

NOTE: Part B coinsurance — the share you’re expected to pay after reaching your deductible — is 20% of the cost for each Medicare-approved service or item. This can make up a significant part of your total out-of-pocket costs.

Part A premiums (for the few who have to pay for Part A), deductibles and coinsurance will increase. They will be $1,632 in 2024, an increase of $32.

More on What To Expect in 2024

For 2024, the Centers for Medicare and Medicaid Services (CMS) says it anticipates premiums for Medicare Advantage plans to stay fairly flat compared with 2023. Average Medicare Advantage monthly premium prices should be $18.50 in 2024, compared with $17.86 in 2023. Around 73% of beneficiaries won’t see any increase at all.

• Due to the Inflation Reduction Act, many Medicare Advantage plans will offer insulin at a $35 copay or less.
• Medicare Part D costs are expected to stay flat overall, but the specifics of the drugs you are prescribed may vary.
• Eligibility for the full Medicare Part D Low-Income Subsidy (LIS, or “Extra Help”) will be expanded to beneficiaries with incomes up to 150% of the federal poverty level. LIS lowers premiums and out-of-pocket costs for prescription drugs.

The threshold for having to pay Medicare’s IRMAA (Income-Related Monthly Adjustment Amount, a high-income surcharge) can be seen here.

Medigap policies are sold by private insurers. Each carrier sets its own premiums. The 2024 annual deductible for Medigap Plans F, G, and J is $2,800.

6. Compare Your Existing Plan to Alternatives

Even if your existing plan works well for you, you should still shop around to see if there is a more cost-effective option.

You can contact your State Health Insurance Assistance Program (SHIP). SHIP (sometimes called by another name) provides free counseling to any Medicare recipient to help people choose a Medicare plan.

You can contact Medicare at 1-800-MEDICARE or Medicare.gov. They have a Medicare plan comparison tool that may be helpful.

The NewRetirement Retirement Planner also enables you to estimate your lifetime medical costs for different coverage types, health conditions and premium levels.

7. Beware of Medicare Scams, and Don’t Believe All the Ads You’ll See

It is illegal for any licensed Medicare agent to make unsolicited contact with you. So, if you get a call, text, or voicemail from someone offering Medicare services, it is a scam.

Do not give out any personal information.

Also, be wary of the barrage of advertising you will likely see during this period.

8. Check Out Ratings on Plans

Once you have identified a plan or plans that may be a good fit for your particular health needs, you can look up how well those plans rate.

Medicare.gov lets you research plan quality and performance ratings.

U.S. News & World Report is also a reliable source. They evaluate all insurance companies and the plans they offer in each state. See the Best Medicare Advantage Plans and the Best Medicare Part D Plans.

9. Cut Your Prescription Costs

Even with supplemental coverage, prescription copays can add up. To save money, discuss your concerns with your doctor. Ask if they will prescribe a less expensive alternative or a generic.

Whatever your doctor prescribes, shop around to fill your prescription. Filling the same prescription at Costco versus CVS could save a lot. Ordering a 90-day supply online may save you even more.

10. Use a Health Savings Account (HSA)

If you’re still working and are eligible to contribute to an HSA, take advantage of it.

Your contributions are made pre-tax, the money in your account grows tax-free, and you can withdraw funds from the account at any time tax-free, as long as the money is used for qualified medical expenses.

Learn more about HSAs: What they are and why they are a compelling savings option.

11. Be Proactive To Stay Healthy

If you are in good health, you’ll spend less on retirement health care costs.

Medicare offers a wide range of immunizations, preventive screenings and well-being programs for free.

12. Factor Out-of-Pocket Medical Costs Into Your Overall Retirement Financial Plan

Out-of-pocket medical costs are one of the three biggest expenditures for most retirees. Studies have shown that the total out-of-pocket Medicare costs are higher than the total Social Security income for the average retiree.

In other words, Social Security income does not even cover what most retirees will have to spend on their health.

So, it is important to make sure that your retirement finances are prepared for this major expense in 2024.