As the end of the year approaches and the annual Medicare open enrollment period begins, it is time to review your current Medicare coverage and determine if any adjustments need to be made. Most people will only make changes due to an increase in premiums or co-pay amounts, but there may be other reasons to consider a change. You have from October 15 until December 7, 2022, to make changes to your coverage.
The Inflation Reduction Act, signed into law on August 16, 2022, does include certain Medicare related provisions. However, these are currently set to roll out over the next several years. Some more significant provisions in the Act and when we can expect those to take effect are discussed below.
- Starting in 2023, deductibles will not apply to covered insulin products under Medicare Part D or under Part B for insulin furnished through durable medical equipment. Also, the applicable copayment amount for covered insulin products will be capped at $35 for a one-month supply.
- Starting in 2025, a $2,000 annual cap (adjusted for inflation) will apply to out-of-pocket costs for Medicare Part D prescription drugs.
- The legislation authorizes the Department of Health and Human Services to negotiate Medicare prices for certain high-priced, single-source drugs. However, only 10 of the most expensive drugs will be chosen initially, and the negotiated prices will not take effect until 2026. For each of the following years, more negotiated drugs will be added.
Here are some of the changes you might consider making to your Medicare plan for this upcoming calendar year:
- Switching from one Medicare Advantage plan to another. If you have elected to use a Medicare Advantage plan, you should have received information regarding any changes to your current coverage. If your premium is increasing significantly, you can consider looking at other plans. Even if your premium is not changing dramatically, you should take this time to confirm that your preferred health care providers are still in your plan’s network.
- Switching from one Medicare Part D prescription drug plan to another. If you do not use Medicare Advantage, or if your Advantage plan does not include prescription coverage and you use a Part D plan for prescriptions, you can consider changing Part D plans during the open enrollment period. If you take at least one prescription drug, it is worth reviewing plans each year at medicare.gov to evaluate the total you will pay for the drugs you take. You may be able to find a lower-cost option, especially if you are flexible in terms of which pharmacy you use or if you get medications by mail.
- Switching from Original Medicare to a Medicare Advantage plan. During open enrollment, you can switch from Original Medicare to Medicare Advantage. PLEASE NOTE: If you currently have a Medicare supplement (Medigap) plan, that plan is guaranteed renewable for life. If you switch to Medicare Advantage, you lose that guarantee, so few people elect to make this change.
- Switching from a Medicare Advantage plan to a Medicare supplement (Medigap) plan. If you are healthy and would like to switch to a Medigap plan to benefit from its guarantees, you may do so during open enrollment. Be aware that you will need to go through underwriting and may pay higher premiums if health issues are identified.
If you wish to make a change to your Medicare Advantage or drug plan, simply enroll in the Medicare Advantage plan or Part D prescription plan you want, and you will be automatically dropped from your previous plan. Remember, the coverage will not be effective until January 1, 2023.
We recommend not waiting until the first week of December to make any changes to your Medicare coverage. The earlier you call, the less time you could spend on hold. To make changes, you can either log in to your account through medicare.gov or call 1-800-MEDICARE.
We partner with a number of professionals who specialize in navigating Medicare options. To learn more, contact your JNBA Advisory Team.
PLEASE NOTE: JNBA is neither an agent of The Centers for Medicare & Medicaid Services, nor an insurance agent. All claiming strategies and benefits must be verified and accepted by The Centers for Medicare & Medicaid Services, no portion of the above should be construed as insurance advice. All insurance issues should be addressed with the insurance professional of your choosing.
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