Expert Tips for Easily Navigating Medicare Open Enrollment in 2023

Retirees and other beneficiaries have until December 7 to make adjustments to their Medicare coverage during the open enrollment period. During this time, you have a choice between Original Medicare (Part A and Part B), which offers benefits directly from the government, and Medicare Advantage plans (Medicare Part C plans), which offer the same benefits but through private insurers and, depending on the plan, additionally cover prescription drugs, dental care, and vision care.

An alternative Medicare strategy might help reduce expenses as inflation squeezes many people's wallets. Changing your plans could also be necessary if your location or medical requirements change.

Given some of the economic constraints we're experiencing, this year is special, according to Bob Rees, vice president of Medicare sales at the online marketplace for health insurance, eHealth.

Continue reading to learn the reasons you might need to switch Medicare plans during open enrollment and how to change your 2023 Medicare benefits.

Reasons to Consider Changing Your Medicare Plan During Open Enrollment

Even though every Medicare recipient has the ability to switch plans during the open enrollment period, it appears that few do so. Less than one-third of Medicare enrollees compared plans in 2019, according to a Kaiser Family Foundation analysis from 2021.

But if any of the following are true, skipping this step might be a mistake.

You’re Moving

Medicare Advantage programs frequently cover a certain region. In the event that you relocate, it could be challenging to locate healthcare professionals that accept your plan, and using out-of-network physicians might result in substantially higher co-insurance charges.

Rees claims that "the plans differ, frequently at the county level."

Keep your existing insurance for the time being if you won't be leaving the area covered by your plan until later in the year. There is a specific enrollment period that permits you to transfer plans after moving once you have left the coverage zones of your current plan.

Your Plan’s Network Is Changing

Medicare Advantage plans frequently function as preferred provider organizations (PPOs) or health maintenance organizations (HMOs), with a network of participating providers. Networks, on the other hand, do not always remain constant over time.

Verify that the medical facilities and chosen providers you like are still part of the Part C network before renewing your existing plan. The formularies for prescription drugs or the list of drugs covered by your plan can also change. During the Medicare open enrollment period in 2022, you might wish to switch coverage if your plan's revised formulary excludes your medication.

You’ve Been Diagnosed With a New Condition

With a new diagnosis of diabetes or cancer, for example, discuss your treatment options for the upcoming year with your doctor. Then verify that your existing Medicare Advantage plan covers any anticipated specialists or drugs.

Your Out-of-Pocket Costs Are Increasing

Occasionally, a plan's premiums or out-of-pocket expenses may fluctuate, which may indicate that it's time to obtain new insurance. Some Medicare Advantage plans don't charge any premiums at all, while others may have reduced or no rates.

According to Rees, "people frequently go to (premium-free plans) as their first choice." But before enrolling in a plan just because there isn't a monthly premium, be sure you understand the co-payment requirements. Paying a premium for a plan that covers more of your expenses is sometimes preferable.

You Want More Benefits

According to a poll done for The Commonwealth Fund, a charity dedicated to enhancing healthcare systems, over half (45%) of Medicare enrollees will be registered in Medicare Advantage plans in 2022. According to the report, over a quarter of people with Medicare Advantage chose such a plan because it offered extra advantages.

Many Medicare Advantage plans include services like eye and dental care that are not included in original Medicare. According to Rees, they could also provide supplemental benefits like gym memberships or transportation insurance.

Even if you're satisfied with your current Medicare Advantage plan, it may still be beneficial to evaluate your alternatives to see if there are any other plans that provide better or more benefits.

You’d Like a Medigap Plan

To "fill the gaps" in Original Medicare coverage, Medicare recipients can acquire Medicare Supplement insurance, often referred to as Medigap plans. Additionally, they may provide advantages not frequently provided by Part C, like supplemental coverage for skilled nursing facilities or emergency medical care when traveling abroad.

A Medigap policy, however, can only be bought by those who have original Medicare. Therefore, in order to get supplementary insurance, you must convert from a Medicare Advantage plan to Original Medicare.

Be aware that if you buy a Medigap policy after the first enrollment period at age 65, you could be required to undergo medical underwriting. This means that the insurance provider may raise your rates in response to changes in your health, which would result in higher costs. As a result, not everyone may be able to purchase a Medigap plan since they may either be refused coverage due to a health condition or be given an exorbitant cost.