- Medicare’s open enrollment, which runs from October 15 through December 7, is a chance to review your current benefits and choose the best plan for 2024.
- Experts recommend reviewing your personal circumstances, such as medical conditions, prescription drugs, preferred doctors and budget.
- You can compare Medicare plans using the government’s plan finder or consulting with a licensed independent broker or agent.
Medicare’s open enrollment, which runs from Oct. 15 through Dec. 7, is a chance to review your current benefits and make changes for 2024.
If you recently had something new come up with your health, finances or other circumstances, open enrollment allows you to choose a health plan and prescription drug coverage that better meets your needs.
Generally, people over age 65 are eligible for Medicare coverage. Some people who are younger than 65 but have certain conditions, such as ALS or kidney failure, are also eligible.
Medicare health and drug plans can also change from one year to the next — things like cost, covered services and drugs, and which health providers and pharmacies are “in network” — so it’s important to review your plan to make sure it’s still appropriate.
Here are some things to keep in mind to help you make the right decision.
Medicare plans fall under two broad categories — the federal government’s Original Medicare and Part D drug supplement and the Medicare Advantage plans offered by private insurers.
In 2023, nearly 4,000 Medicare Advantage plans were available nationwide, according to nonprofit KFF. Almost nine out of 10 plans included prescription drug coverage.
What is Medicare type A and B?
Original (traditional) Medicare includes:
- Medicare Part A: Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, inpatient rehabilitation treatment, and some home healthcare services.
- Medicare Part B: Covers physician services, outpatient care from a hospital, certain home health services, medical equipment, and preventive and screening services.
What is Medicare type C and D?
An option to buy supplemental coverage (Medigap) from a private insurer. This helps pay out-of-pocket costs such as copayments, coinsurance, and deductibles. Some Medigap plans also cover services not covered by Original Medicare, such as care while traveling outside the country.
Medicare Advantage (also known as Part C), offered by private insurers:
- Includes coverage for all of Part A and Part B benefits.
- Usually includes coverage for Part D (prescription drug)
- Does not cover costs for clinical trials and hospice care, but Original Medicare will help cover those costs.
- Plans may not cover services that are not medically necessary.
- Plans may offer coverage for things Original Medicare doesn’t cover, such as gym memberships; vision, hearing, and dental services, transportation to doctor visits, and over-the-counter drugs.
- You may need to get a referral to see a specialist.
- In most cases, you can only see a doctor who is in the plan’s network. Some plans offer non-emergency coverage out of network but typically at a higher cost.
While most of the Medicare benefits are the same as in previous years, there are some new offerings for 2024.
“This allows individuals on Medicare to access more virtual care options,” he told Healthline, “making it easier and safer to receive medical treatment during the ongoing pandemic.”
“There have also been updates to Medicare Advantage plans,” he said, “with some offering new benefits such as coverage for adult day care services and transportation to medical appointments.”
If you had Medicare this year and are satisfied with your coverage, you don’t need to do anything. You will be automatically re-enrolled in the same plan, as long as it is still available.
Most experts, though, recommend that you review your health care plan and drug coverage to make sure it matches your current circumstances.
Also, “plans can change from year to year, so it’s important to make sure your current plan still meets your needs and budget,” said Tunis. “If you find that another plan offers better coverage or lower costs, it may be worth switching during the open enrollment period.”
Samantha Sizemore, chief operations officer for Tennessee-based Holston Medical Group, cautioned that plans may change not only which services are covered, but also the premiums, deductibles and other out-of-pocket costs.
In addition, “each plan is a little different, so you’ll want to think about the care you need,” she told Healthline.
But no matter which plan you choose, all Medicare enrollees have access to preventive and screening services.
“These include coverage for things like vaccines, tests, screenings, and even yearly wellness visits,” said Sizemore. “These services can help keep you healthy and catch problems early.”
Tunis recommends spending time researching and comparing different plans to find one that best fits your needs and budget.
“Before choosing a Medicare plan, it’s important to consider your current health needs and any potential changes in the upcoming year,” said Tunis. “This can include chronic conditions, prescription drugs and preferred doctors or hospitals.”
You can use the government’s Medicare plan finder, or consult with an independent agent or broker who can help you compare all plans.
“We always recommend talking to a neutral third party or someone whose job it is to help you understand and weigh your options,” said Sizemore.
Independent agents and brokers must be licensed by the state where they do business and follow strict rules about marketing Medicare plans.
The National Association of Insurance Commissioners and the National Association of Benefits and Insurance Professionals have online databases of licensed professionals.
Tunis said you can also ask your doctor or other healthcare provider for their guidance.
“They can review your options and offer personalized recommendations based on your [medical] needs,” he said. “They can also explain any changes to Medicare coverage and how they may affect you.”
When reviewing your plan, keep in mind the following:
- Doctors: If you have Medicare Advantage, check to see if your doctors are still included in your network. This isn’t necessary if you have Original Medicare, because it covers all doctors who accept Medicare.
- Prescription drugs: Check to see if the drugs you are currently taking, or expect to be taking next year, are covered by your plan and if the cost has changed. This applies to both Part D coverage added to Original Medicare and to Medicare Advantage plans.
- Costs: Check to see if there have been changes to your premiums or out-of-pocket costs. Keep in mind that plans with zero premiums may have higher out-of-pocket expenses. “It’s important to assess your budget and determine what you can comfortably afford for monthly premiums, deductibles and out-of-pocket costs,” said Tunis.
While some plans cover special services like free gym memberships or savings on over-the-counter medications or medical supplies, this is only a good deal if you use them.
“So look for a plan that covers what you need without paying for what you won’t use,” said Sizemore.
Medicare’s open enrollment is a good opportunity to review your current benefits and find a health plan and drug coverage that fits your medical, financial and personal needs.
Many plans are available, including the Original Medicare — with the option to add prescription drug coverage — and Medicare Advantage plans, most of which include drug coverage.
Medicare Advantage plans offer coverage for all of the services covered by Original Medicare, but may also offer other benefits such as gym memberships and transportation to doctors’ appointments. All plans cover preventive and screening services.