Work & Money

Money: Medicare Update

It’s coming up on that time again – Medicare re-enrollment. It’s the time to review your health care options and decide if you are going to stick with your current Medicare plan for the next year.

Medicare Basics

But first, it’s time to review what you have.   Medicare open enrollment runs from October 15 to December 7 each year. If you are enrolled in Original Medicare (Parts A and B) or a Medicare Advantage Plan, you will be automatically re-enrolled unless you opt out.

Original Medicare is the plan run by the government. Medicare Advantage Plans are operated by private health care companies contracted by the government. Medicare Advantage bundles Parts A, B and D (the prescription drug plan). But usually, you have to use doctors in that plans network. Many Medicare Advantage plans also offer dental and vision plans, which are not covered by Original Medicare.

All the Medicare changes, including plans, prices and deductibles aren’t yet available.

Medicare: Steps to take

Lisa Humes, a licensed insurance agent at HealthMarkets says even though we are near the opening of the season, all the Medicare changes, including plans, prices and deductibles aren’t yet available. She also cautions Medicare plan participants to pay attention to the annual notice of change.

“See if your plan premium is changing,” Humes says. “But not only that, what do your prescription costs look like for 2024?  A lot of carriers have now gone to Tier 3 percentage or coinsurance instead of a set co-pay. That can mean an increase in costs. Sometimes it can mean a decrease, but more than likely it’s going to be an increase in prescription prices.”

The Medicare prescription drug tiers

  • Tier 1: Preferred generic drugs – The lowest tier contains the cheapest, commonly used generic drugs.
  • Tier 2: Generic drugs – Higher-cost, common generic drugs.
  • Tier 3: Preferred brand drugs – Brand-name drugs without a lower-cost generic equivalent.
  • Tier 4: Non-preferred drugs – Higher-cost generic and brand-name drugs with a lower-cost generic equivalent.
  • Tier 5: Specialty drugs – Unique and/or high-cost generic and brand-name drugs.

“Your medicine might be a Tier 1 on someone’s plan,” Humes says. “It could be a Tier 2 on somebody else’s.”

“It’s a common misconception that just because you take a particular medication, it is always going to be at a certain tier but it might not be with a different insurance company or a different plan.

“So, checking those things out can mean a big difference sometimes in the cost over the course of the year on what you are paying for medication,” she says. “And, of course, using the preferred pharmacy so that you get that cheapest cost and copay that you can for your drugs.”

Medicare Choices:  Timing Matters

The important thing this year, as in any year, it to review your coverage. It could be time for a change. Philip Moeller, author of “Get What’s Yours or Medicare,” advises that you wait until November to lock in your choices.

The Kaiser Family Foundation, which does wonderful assessments of Medicare trends, does a really good deep dive into plans, but it’s not going to be out until late October or early November,” he says.

“I advise people to wait until the middle or late November to actually make their 2023 elections.”

“It takes some time to analyze all these newly filed plans and come up with trends, which I find are very important for consumers to look at. So having said that, I advise people to wait until the middle or late November to actually make their 2023 elections. Any change may be made at the latest December 7, which is the end of the annual period and will still take effect that January.

“I just think people should sort of do their homework which I say every year,” he says, “The experts say people don’t do their homework.”

“If you don’t take any medications, you’re happy with your plan and everything is going wonderful, then maybe you don’t need to do anything,” adds Humes.  “But that’s usually a very small percentage of folks. More folks need to look at it and just review it to make sure that they’re good with what what’s happening in their plan.”


Are you changing your plan or standing pat? Why? Let us know in the comments!

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Rodney A. Brooks is the former deputy managing editor/Money at USA TODAY. His retirement columns appear in U.S. News & World Report and Senior He has written for National Geographic, The Washington Post and USA TODAY. The author of “Fixing the Racial Wealth Gap,” Brooks has testified before the U.S. Senate Special Committee on Aging. His website is


Your use of any financial advice is at your sole discretion and risk. and Older Adults Technology Services makes no claim or promise of any result or success. 


20 responses to “Money: Medicare Update

  1. Be careful about switching plans. I used a broker supplied by my company to help with Medicare decisions. In a few years, I decided to talk to them about making a switch. I was elated with their reccs for both a new Medicare and drug plan. More for less$!!!
    In a few weeks, I received a note from Medicare that said if I made the switch, my monthly premium would double. Underneath that, was literal chicken-scratch with a pencil a (misspelled) medical test I had taken as the reason. SMH

  2. The senior center in my county offers, by appointment, specialists to help decipher each available plan in this specific county (offers, especially Medicare Advantage Plans, differ by county). If I decide to go with a Medigap plan, the specialist explains each option clearly. I highly recommend contacting your local county to find out how to get specialized help. I happen to live in a senior building and a representative came onsite to address us.

  3. I’ve been on Medicare since 2013 between disability and age. During that time I did most of my own homework and chose my own companies but even with internet and some business savvy I made some mistakes.
    I would strongly suggest that people new to Medicare find an independent insurance agency experienced in offering all options of Medicare coverage to their clients. I’m doing that this year despite (or because of?) my past experience. This year seems more important than other years have been.

  4. Hi I am new to this and hoping that I be able to get some type of coverage because I dont want to be not qualifed due to my age.I was forced out of work because i was in an accident.Needed to get SSDA.Now,I am sixty-two years old,will l qualfy for Medicare Advantage Plan?,I retired and
    I beeb out of work for about twenty-two month.I worked for about twenty-one years.Please send me some good information about Medicare which includes med8cation included and thanks for your information.

  5. As a Medicare Expert that began with my workshops in NYC in 1988 one of the biggest problems for Beneficiaries is false political noise, arcane Medicare rules & complexity, and mistakes made by novice Agents and Non-Insurance Experts like the misleading info suggested by the writer. By that I mean Medicare Members who have made the right choice of a Plan do not need to review things every year , or be concerned with the AEP, or OEP unless there is a change in their needs.

  6. As a leading Health Insurance Expert advising Medicare Members for more than 30 years Medicare is the absolutely best and most affordable ( Medicaid is only available for very low-income families with coverage that varies by county and a high degree of complaints as to the poor quality and lack of providers ) health insurance in our Country and Medicare Advantage Plans the best choice for most people. I will summarize ” Why” below: There is no need to change plans every year!

  7. We took a look at “Advantage” plans and did some external research. It became clear that “Advantage” health care a scam on the American public, introduced by a politicians who are opposed to government services like Medicare. ADvantage companies make hundreds of millions of dollars by denying care ; have been found guilty of fraudulent billing, costing hundreds of millions. Free gym membership isn’t worth denial of care. Medicare is universal health care at its best.

    1. The first line of the response by rsp ” health care scam ” is a good example of slander based on a ridiculous falsehood as more than half of all Medicare Members choose Medicare Advantage Plans for important and clear benefits some of which like ” Care Management and Nurses available at no cost over the phone cannot be had any other way. Medicare Advantage Plans has been the best choice for most beneficiaries for almost two decades now because : They offer the most benefits at the lowest cost.

    2. I agree. I did a year of research, which included being part of Boomer Benefits facebook Q & A page. BB is a Medicare plan agency that does business in 49 states. Many people don’t realize MA plans aren’t Supplement. Many people get MA plans because all they see is $0 premiums. They don’t look into the nitty-gritty details. My sister got a MA plan from an agent because he told her it would cover the 20% Medicare didn’t. She thought she was getting a great deal on a Supplement/Medigap plan.

    1. There is no need for ” a webinar on selecting a Pt D Plan ” for a number of simple reasons: 1- All Part D Plans must provide coverage from Medicare’s Mandatory List so meds covered will be similar in cost and how covered.
      2- The best way to get Part D Coverage is often inside of a MAPD which will save the cost of a standalone plan.
      Unfortunately, most people with standalone plans are already wasting a fortune on Medicare Supplements instead of choosing MAPD’s.

      1. I disagree. With Medigap/Supplement Plan N, I pay the Part B deductible, up to $20 copay for some Dr office visits & up to $50 for ER visits if not admitted, that’s it. I don’t pay a dime for PT which often has a $30/$40 copay per session. There is no copay for X-rays or bloodwork. I don’t have to worry about managed care…pre approvals or denial of services. The Part A deductible is covered for inpatient services. My drug plan is $5/month & I can get one for $0 in 2024.

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