Dear Addy,
I am a Medicare beneficiary weighing my plan options for 2022. What do I need to know about choosing a plan for the coming year?
Medicare Beneficiary
Dear Beneficiary,
Every year Medicare Open Enrollment runs from October 15 through December 7. This is the time of year when you can decide to stay with the Medicare plan you are currently on, or you can change to a new plan. Medicare has a lot of moving parts and can be confusing, so it’s good you are starting your research now.
What is Medicare? Â
Medicare is a government health insurance program administered by the Centers for Medicare and Medicaid Services for individuals 65 years or older, and for individuals with a qualifying disability. Original Medicare includes hospital insurance (Part A) and medical insurance (Part B); you can also add prescription drug coverage (Part D) and Medicare Supplement Insurance (Medigap, which covers deductibles for Part A and B that original Medicare doesn’t cover). Important note for people with bleeding disorders: clotting factor (and new, non-factor hemophilia medication) is covered under Medicare Part B and not under the Part D drug benefit.
As an alternative to original Medicare, you can choose to purchase an “all-in-one” privately-issued Medicare Advantage plan that covers all your hospital and medical services (Part A and Part B). Most Medicare Advantage plans also offer prescription drug coverage (Part D). If you opt for a Medicare Advantage plan, you cannot also have a Medigap supplemental plan.
Choosing the right plan
- If you currently are on a Medicare plan, you should review your provider’s Evidence of Coverage (EOC) and Annual Notice of Change (ANOC) to ensure that your plan will still meet your needs for the following year.
- If your existing plan no longer best serves your needs, you can change your coverage between October 15 – December 7. You can switch among Medicare Advantage plans and prescription drug coverage (Part D); you can also switch from Original Medicare to Medicare Advantage, or vice versa, during this time. Your changes will take effect on Jan. 1, 2022. If you do not pick a new plan, you will be automatically renewed in your current coverage.
- Those with traditional Medicare who purchased a Part D plan to cover their prescription drugs (remember, Part D does not cover injectable bleeding disorders products) may want to review their existing plan to ensure it continues to offer the best coverage. This is especially true if you have changed medicines in the past year. Further, health plans at times transfer drugs to different coverage levels from year to year, so do not assume your current coverage will be the same going forward. Medicare Advantage plans may also change from year to year, so it is imperative that you review your coverage under the private insurance companies that manage your plan.
You can learn more about your Medicare options at www.Medicare.gov and your State Health Insurance Assistance Program (SHIP).
