Questions to Ask During Medicare Open Enrollment
Medicare open enrollment is a critical time of the year when beneficiaries have the chance to review their plan options and make any changes necessary to their coverage. That’s why it is important to go into open enrollment having gone over the answers to several questions about your current coverage to better inform your decision-making.
- Written by Christian Simmons
Christian Simmons is a writer for RetireGuide and a member of the Association for Financial Counseling & Planning Education (AFCPE®). He covers Medicare and important retirement topics. Christian is a former winner of a Florida Society of News Editors journalism contest and has written professionally since 2016.Read More
- Edited ByLamia Chowdhury
Lamia Chowdhury is a financial content editor for RetireGuide and has over three years of marketing experience in the finance industry. She has written copy for both digital and print pieces ranging from blogs, radio scripts and search ads to billboards, brochures, mailers and more.Read More
- Reviewed ByEric Estevez
Owner of HLC Insurance Broker, LLC
Eric Estevez is a duly licensed independent insurance broker and a former financial institution auditor with more than a decade of professional experience. He has specialized in federal, state and local compliance for both large and small businesses.Read More
- Published: August 19, 2022
- Updated: April 21, 2023
- 5 min read time
- This page features 3 Cited Research Articles
- Edited By
When Is Medicare Open Enrollment for 2023?
Medicare open enrollment will last from Oct. 15 to Dec. 7. During that period, you can review your coverage options and make necessary changes if you are eligible.
This can include switching from Original Medicare to Medicare Advantage, switching back to Original Medicare from a private plan or adding on a Part D prescription drug plan, among other things.
- Switch from Original Medicare to Medicare Advantage
- Switch from Medicare Advantage to Original Medicare
- Switch from one Medicare Advantage plan to another
- Purchase Part D prescription drug coverage
Even if you don’t believe you have any issues with your current coverage, it may still make sense to go over your options.
Medicare is updated every year, from premium changes to new private plans available in your area. Researching your options can help to ensure that you are not missing out on a better plan.
There is an additional enrollment period for beneficiaries who already have Medicare Advantage to make changes after open enrollment ends as well. That period lasts from Jan. 1 to March 31.
Questions to Think About Before Open Enrollment
When heading into open enrollment, you should ask yourself several questions about your current coverage. Answering these questions can help you know what to look for during open enrollment and to make the right choices for your coverage.
1. Can You Afford Your Current Plan?
You certainly don’t want to end up in a position where you cannot afford your health coverage. If you were struggling to pay your premiums last year, then it may be time for you to switch to a cheaper plan.
According to the Kaiser Family Foundation, Medicare Advantage was more than $300 more expensive per person in 2019 than Original Medicare.
If you have a private plan and are unable to afford it, then you can use open enrollment to switch back to Original Medicare. If you’re struggling to pay for Original Medicare, then you may be eligible for the Medicare Savings Program if your monthly income is below a certain limit.
You can call Medicare or your State Medical Assistance office to get more info.
2. Does the Plan You’re in Cover Prescription Drugs?
Remember that Original Medicare does not include Part D. So if you have Original Medicare, you do not have prescription drug coverage.
You may want to look into purchasing a standalone Part D plan if this is the case. The standalone plan acts on its own so it can be paired with Original Medicare and offer you coverage.
Many Medicare Advantage plans include prescription drug coverage. If your plan does not, then you can research and switch to a plan available where you live that does.
3. Will You Need Dental or Vision Coverage Over the Next Year?
Dental and vision coverage may become more important to you as you age, since these are areas that can worsen as time goes on.
If you are expecting to need dental or vision coverage in the next year, then it naturally makes sense to switch to a plan that offers it.
Original Medicare does not offer dental or vision coverage and you cannot get it through a Medigap plan either. You’re only option for coverage is to switch to a private plan.
Medicare Advantage plans typically include both dental and vision coverage, but the exact level of coverage will vary from plan to plan.
You should research the plans available to you to compare dental and vision offerings.
4. Were You Diagnosed With a New Illness?
If you were diagnosed with a new illness in the last year, then it may make sense to determine if your current plan is the best option for combatting that illness.
Depending on your condition, you may find that a different plan offers more coverage for the treatment and services that you need. A different plan may be more advantageous in terms of when and how you pay as well.
You may also find that your current plan provides the coverage that you need. But you should still consider researching your other options to ensure you are not missing out on a plan that better suits you.
5. Do My Doctors Accept My Current Medicare Plan?
If your doctor does not accept your current Medicare plan, then it is very likely that you will need to find another plan. If not, then you will need to find another doctor.
The majority of the doctors in the United States accept Original Medicare, so it would be unlikely that you would have this issue if you are enrolled in Original Medicare.
Medicare Advantage plans do often require you to receive care within a plan network. So if you joined a private plan and your doctor was not included in that network, you would have to find an in-network care provider.
6. How Much Traveling Do You Typically Do?
Medicare Advantage plans are available regionally, and many require you to stay within a plan network.
If you are planning to be on the move a lot or splitting your time between different parts of the U.S. in the coming year, it may make sense to opt for Original Medicare, since you’re covered at any doctor enrolled in Medicare.
And if you are planning on spending lots of time abroad, your only option for international coverage is through Medigap. Supplement insurance has its own open enrollment period that lasts for six months after you first have Part B.
If you miss this window, it may be difficult to get a Medigap plan, depending on the state you live in.
3 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2022). Joining a Health or Drug Plan. Retrieved from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan
- Kaiser Family Foundation. (2021, August 17). Higher and Faster Growing Spending Per Medicare Advantage Enrollee Adds to Medicare’s Solvency and Affordability Challenges. Retrieved from https://www.kff.org/medicare/issue-brief/higher-and-faster-growing-spending-per-medicare-advantage-enrollee-adds-to-medicares-solvency-and-affordability-challenges/
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Get help with your Medicare costs. Retrieved from https://web.archive.org/web/20230127124212/https://www.medicare.gov/Pubs/pdf/10126-Getting-Help-With-Your-Medicare-Costs.pdf
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