October represents a crucial time for Medicare beneficiaries seeking to optimize their healthcare and drug coverage. Each year, from October 15th to December 7th, those eligible to participate in Medicare’s Annual Enrollment Period (AEP) can opt to make changes to their healthcare and prescription drug coverage for the upcoming year.
Given rising drug costs, fluctuations in access to providers, and potential changes to personal health, many reasons exist to reassess the effectiveness of existing plan selections. The sheer volume of choices, especially among Medicare Advantage plans, can be reason enough to take stock. For example, the average beneficiary now has 43 Medicare Advantage plans from which to choose, the highest number of options ever available.
Who can participate in AEP?
Anyone enrolled in Original (or “Government”) Medicare can choose to make changes during the AEP. Additionally, anyone receiving their benefits through a Medicare Advantage Plan or enrolled in a Medicare Part D Prescription Drug coverage plan can participate in the Annual Enrollment Period. Those who missed their chance to enroll in Medicare during their Initial Enrollment Period must wait for the General Enrollment Period (GEP) to enroll in coverage. The GEP lasts from January 1st through March 31st each year.
Beneficiaries who have purchased a Medicare Supplemental “(or “Medigap”) plan do not qualify to participate in the AEP. It may be possible, however, to switch from a Medicare Advantage plan to Original Medicare and add a Medicare Supplement plan. In addition to potentially requiring medical underwriting, this step may be costly if it does not coincide with the beneficiary’s Medigap Open Enrollment Period.
Available changes during the Annual Enrollment Period
Medicare beneficiaries can choose to make a variety of changes during the Annual Enrollment Period, all of which will take effect on January 1st of the following calendar year:
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- Switch Medicare Advantage plans (with or without a Part D plan);
- Add, drop, or change Medicare Part D Prescription Drug coverage; or
- Move to/from Original Medicare to a Medicare Advantage plan.
Additional cost savings for drug plans in 2024
With the enactment of the new prescription drug law under the Inflation Reduction Act (IRA) earlier this year, some helpful cost savings measures go into effect starting in 2024. These may be worth factoring into any changes being considered during the AEP.
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- Lower coinsurance payments may apply for certain drugs and biologicals covered by Medicare Part B if the prices have increased higher than the rate of inflation (this can change every quarter).
- Copayments will not apply starting in 2024 if a beneficiary has drug costs high enough to reach the catastrophic coverage phase in their Medicare drug coverage.
- The Part D Low-Income Subsidy (LIS) program will expand to cover more drug costs for those earning less than 150% of the federal poverty level.
- There will be no out-of-pocket costs or deductible impact for those with Medicare Part D when getting one of the Advisory Committee on Immunization Practices (ACIP)-recommended vaccines.
- For those using an insulin pump covered under Part B’s durable medical equipment benefit or those getting their insulin through a Medicare Advantage Plan, a month’s supply of Part B-covered insulin cannot exceed $35 as of 2024.
Speak with an experienced Licensed Insurance Agent and make an informed decision
With so many options to consider and opportunities to save on costs, taking time for an evaluation during the AEP can be helpful to ensure your unique financial and medical needs are being met. Contact Aevo Insurance Services, a division of Brown & Brown Absence Services Group, to speak with an agent about your Medicare options. Guidance extends through every step of the enrollment process.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.
