There’s no doubt that choosing or changing a health insurance plan can be confusing and overwhelming. A plan that worked a few years ago may not meet your current needs. Or you might still be working at age 65 but never enroll in school.
These rules can be confusing, so before you make any decisions or change your current plan, do your homework carefully to avoid potentially costly mistakes and ensure you receive the new benefits enacted in 2022 Inflation reduction methodCenters for Medicare and Medicaid (CMS) Administrator Chiquita Brooks LaSure said.
If you would like to make changes, you can do so during the open enrollment period from October 15th to December 7th each year. Current Medicare beneficiaries (including those in Medicare Advantage plans) can enroll in or change their Part D prescription drug coverage, switch between Medicare Advantage (MA) plans may be somewhere between MA and traditional Medicare coverage.
New health insurance registrations are usually only before, during or after your 65th Birthday month. If you miss that window, you’ll have to wait until the first quarter of the year (anytime between January 1 and March 31) to register.In some cases, you may have to pay fine.In other cases, you may be eligible for special enrollment period and avoid additional lifetime surcharges.
New benefits save recipients money
Some of the benefits of the Inflation Reduction Act are already taking effect. These include a $35 monthly cap on insulin and coverage of all CDC-recommended vaccines for anyone 65 or older. Brooks LaSure emphasized eliminating cost-sharing for the shingles vaccine, an option that previously often cost seniors hundreds of dollars out of pocket.
Other benefits will be rolled out over the next few years, including limits on prescription drug costs. Eligibility for the Low Income Subsidy Program, extra help It will also expand in 2024. The program helps more people afford the premiums, deductibles, coinsurance and other costs of a Part D prescription drug plan.
“There are currently about 3 million eligible people who are not enrolled in (extra help),” she said. “We do want to emphasize that people sign up to get extra help with their prescription medications.”
The Inflation Lowering Act would reduce the cost of top-priced drugs over the next few years through direct negotiations with pharmaceutical companies.But even if your medication doesn’t on the list BrooksLaSure said that among the first 10 drugs in the program, she has seen some pharmaceutical companies begin to voluntarily limit or reduce the prices of other drugs.
One of the additional benefits noted by the Director is more comprehensive coverage of mental health services. “So marriage and family therapists and mental health counselors are included, which is a very exciting change for the Medicare program,” she said.
Meanwhile, as millions of current and new Medicare beneficiaries evaluate which coverage is right for them, Brooks LaSure offers some advice to avoid common and costly mistakes:
1. risk lifelong punishment
Original Medicare coverage (Parts A, B, and D) or Medicare Advantage (including Part D) should usually be included in your Initial eligibility window. Some MA plans may “bundle” prescription drug coverage under a comprehensive plan, while other plans require separate Part D enrollment. Lifetime penalties can be expensive.For example, delaying enrollment in Medicare Part B would result in life punishment For each year of delay, an additional 10% is payable. This fee is added to your monthly premium. 2021, More than 700,000 people Penalties will apply to those who are not eligible for deferral of Part B enrollment. (Part D penalty figures have not yet been released).
2. Not understanding the criteria that may allow you to defer admission
If you are still working and have equivalent employer coverage or coverage through your spouse’s job, You may not need to register Medicare is available at age 65. However, even CMS administrators admit that these rules are challenging because standards vary from employer to employer. She recommends calling 800-MEDICARE to speak with an expert who will walk you through your options and explain how to avoid financial penalties.
3. Not purchasing supplemental insurance early enough
The initial Medicare enrollment period is when you should purchase supplemental insurance (Medigap) because it is guaranteed. This private insurance closes the “gap” between what Original Medicare pays for services and what beneficiaries pay. It only applies to those on traditional Medicare plans. If you try to purchase later, such as when switching from Medicare Advantage to Original Medicare, the insurance company is under no obligation to issue a policy. Or, you may be required to receive medical coverage, resulting in higher premiums.
4. Not reviewing your Part D prescription drug plan every year.
Formulary changes. Your health may also change. A drug plan that was in effect last year may not cover your recently prescribed new drug, or it may be prohibitively expensive. Open enrollment is a time to review your current prescription plan and see if there are better financial options. A slightly higher premium may be enough to offset covered new drugs that might otherwise cost hundreds of dollars each month.
5. Not reviewing your Medicare Advantage plan provider list and coverage every year
The plan must notify beneficiaries of any significant changes in coverage or benefits, including copayments, coinsurance, and deductibles. A procedure or treatment that was once covered may no longer be covered, or may require a higher out-of-pocket cost. Also keep in mind that the program’s list of providers may change. A specialist or hospital you regularly visit may no longer accept a specific plan. Open enrollment lets you switch to another Medicare Advantage plan or Original Medicare so you can find the care you need. Even if you are penalized, the trade-off may be worth it if it means seeing a healthcare provider of your choice and receiving the treatment, services, or medications you need with confidence.
“As a Medicare beneficiary, it’s important to review these health plans from trusted sources,” said Brooks LaSure.To find a plan that suits your needs, she recommends checking out Medicare and you Manual, updated annually.The brochure and Medicare website will guide you through Available plans in your area. And, she warns, don’t be swayed by slick marketing materials or slick advertising. Administrators say companies make a lot of promises, but the reality is that coverage networks for additional services, such as dental or vision, are often very limited and may not be able to accept new patients.
Other free options to help you choose the best coverage and ensure you get the benefits you need include:
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