Medicare Open Enrollment Rewards Homework, So Do It!

Welcome to my annual plea to spend time on Medicare’s annual enrollment process for next year. Beginning Oct. 15 and extending through Dec. 7, you can switch your current Medicare coverage, with no penalties, for plans taking effect on Jan. 1, 2022.

I wait each year to do this story until the Kaiser Family Foundation has released is initial assessments of next year’s private insurance plans for Medicare Advantage (MA) plans and stand-alone Part D plans.

Kaiser just released these reports and, as usual, they contain compelling reasons to shop around for better deals next year. Unfortunately, as Kaiser notes every year, very few Medicare beneficiaries do so, and many wind up paying more for less coverage.

Most experts lament how complicated Medicare private insurance plans have become. But the range of choices in passenger cars and trucks is even more daunting, and people manage to cope. I have not yet heard compelling reasons to return to the era of Model T Fords, yet many people believe reducing consumer Medicare choices would help consumers.

Perhaps, but sorting through the maze of available MA and Part D plans doesn’t have to be so complicated if people focused on their individual needs and not on the complexity of private offerings. This is what we do with vehicle purchases and we can do the same thing with Medicare.

Medicare Advantage

“Most Medicare Advantage plans (89 percent) include prescription drug coverage. Fifty-nine percent of these plans do not charge any additional premium beyond Medicare’s standard Part B premium,” the Kaiser MA report says. “More than 90 percent of non-group Medicare Advantage plans offer some vision, telehealth, hearing, or dental benefits.”

If you have an MA plan, make sure the doctors and other health professionals you use will still be “in network” next year. The easiest way to find out is to call their offices, not to wade through 30 or even more insurance-plan details.

Your next step is to focus on what the plans offer beyond the Part A (hospital) and Part B (doctors, outpatient, and medical equipment) coverage that Original Medicare and MA plans all must cover. More than 90 percent of MA plans provide vision, dental, hearing, fitness, and telehealth benefits. See which ones are important to you and make sure any MA plan you consider covers these items.

MA plans are touting their expanded non-medical coverage as well, but Kaiser notes that very fewer than 7 percent of standard MA plans have begun offering these benefits, which may include help paying for and delivering food and meals, pest control, transportation, and indoor air quality. MA Special Needs Plans (SNPs) that cover people with serious medical needs, including multiple chronic illnesses, cover between 8 and 20 percent of these items.

Part D Plans

It really pays to explore a new Part D plan.

“Nearly three-fourths, or 10 million, of the 13.3 million stand-alone drug plan enrollees who don’t qualify for low-income subsidies will have to pay higher premiums next year if they stick with their current plan,” Kaiser reports, “and many will also face higher deductibles and cost sharing for covered drugs.”

“The estimated average monthly premium for Medicare Part D stand-alone drug plans is projected to be $43 in 2022, based on current enrollment,” Kaiser added, “while average monthly premiums for the 16 national stand-alone drug plans available in 2022 are projected to range from $7 to $99.”

Shopping Tips

Your online Medicare account contains details of your current plans, including your prescription drugs. It is relatively easy to add or subtract drugs from these lists and to screen both MA and stand-alone Part D plans to make sure they cover your meds and how much you would pay for them next year. These out-of-pocket projections – NOT plan premiums – should guide your choice.

Medicare’s Plan Finder can help with your initial search, but you may need to visit individual insurance websites or, gulp, even call insurers to get missing details.

My current Part D plan sent me 2022 plan changes, which all Plans are required to do by the end of September each year, that showed it was going to quadruple my premiums next year. It took me no more than 10 minutes to find a much better deal that saves me money and covers all of my prescribed drugs.