Senior Care

What to Know About Medicare Open Enrollment

For seven weeks near the end of each year, Medicare recipients can look at different coverage plans and potentially change them. Our experts explain how it works and why some people may want to change their plan – or should keep it.

Nov. 15, 2022 5   min read

For health care plans, the end of the year is the time when most people choose their health care coverage for the following year. People who use Medicare may receive suggestions or offers in the mail, telling them which Medicare health and drug plans to choose.

When is open enrollment?

Open enrollment is a period of time during which people who use Medicare have the opportunity to change their Medicare plans. This year, it runs from October 15 through December 7.

Any changes in a Medicare plan becomes effective on January 1 of the following year.

Changes to Medicare plans

Each year, Medicare health and drug plans change some parts of their coverage. Some of these changes may include

  • Cost
  • Services covered
  • In-network and out-of-network providers
  • In-network and out-of-network pharmacies

These changes are sent to Medicare participants in the form of an Evidence of Coverage (EOC) or Annual Notice of Change (ANOC) document. Regardless of the plan participants are enrolled in, they should review these materials to ensure they are still receiving the coverage they need.

For participants in PACE program, there is often no need to change any plans.

“Medicare participants will likely receive offers in the mail and see ads online that offer different plans,” said Kathy Ralston, director of business development with ElderONE. “For those taking part in ElderONE, most participants will not need to change anything about their coverage. If they have questions about a different program, they can bring them up to our staff on site.”

Considering different options

When looking at Medicare plans, different people have different needs to consider. It may be helpful to make a list of what you want to have covered by insurance in the coming year. This may include:

  • Overall cost
  • Prescription drug coverage
  • Existing provider coverage
  • Additional benefits (e.g., vision, dental, hearing, etc.)

Medicare has a free online tool to compare available plans.

After reviewing Medicare plans, some may find they want to stay with their current plan. In this case, no action needs to be taken and coverage will continue into the following year.

If participants want to change their plan, they have until December 7 to do so. After this, they will remain with the coverage plan they currently have in place.

Support for Medicare choices

Making decisions about Medicare enrollment can be overwhelming and confusing. Thankfully there are individuals and organizations who are available to help navigate these choices.

Organizations such as Lifespan have certified Medicare counselors who offer free confidential assistance in understanding Medicare plans and choosing the best option. Some of the choices they can help with are:

  • Applying for Medicare
  • Assistance with paperwork and health insurance issues
  • Medicare Part D coverage
  • Medigap coverage
  • Medicare Advantage programs
  • Medicare fraud and abuse detection

People enrolled in PACE programs, such as ElderONE, can speak with a social worker about these potential changes, as well.

NEXT STEPS Enhancing the Lives of Our Seniors

An affiliate of Rochester Regional Health, ElderONE is the area’s only PACE program enabling seniors 55+ with chronic care needs to remain independent at home, while still receiving the care and support they need. Offering a full continuum of medical care and social services, ElderONE provides a safe, convenient alternative to nursing home placement.

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