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.”

YOUR TURN

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 Planet.com. 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 www.rodneyabrooks.com.

 

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