Medicare Advantage Open Enrollment: Review Your Coverage Options
During the open enrollment period ending March 31, Medicare Advantage enrollees can switch plans or transfer to Original Medicare.
Why Review Your Medicare Advantage Coverage?
* Provider Network Changes: Medicare Advantage plans have specific networks of providers, and these networks can change frequently.
* Drug Coverage and Cost: Medicare Advantage plans may make changes to formularies and preferred pharmacies, impacting drug coverage and costs.
* Plan Changes: Plans can adjust premiums, deductibles, and coverage, including dental, hearing, and vision care.
Disadvantages of Medicare Advantage:
* Limited provider networks
* Prior authorization requirements for out-of-network providers
* High out-of-pocket costs if out-of-network provider services are not covered
Benefits of Medicare Advantage:
* Includes benefits not covered by Original Medicare, such as drug coverage, eyeglasses, and fitness classes
* Often low or no premium costs
Important Changes for 2025
* Drug cost cap of $2,000 per year out-of-pocket for prescription medications covered by Medicare Part D.
* Reduced deductibles and co-pays for prescription drugs.
Switching to Traditional Medicare
* Requires supplemental coverage (Medigap) to cover out-of-pocket costs.
* Guaranteed right to purchase Medigap is limited to the first enrollment period.
How to Get Help
* Contact your State Health Insurance Assistance Program (SHIP) for free counseling.
* Call the Medicare Rights Center at 800-333-4114.
* Contact Medicare directly at 800-633-4227.
* Use the Medicare Plan Finder tool to compare plans and estimate costs.
Tips for Switching Plans
* Review your current plan and identify any changes that may impact you.
* Consider your provider network, drug coverage, and out-of-pocket costs.
* Research different Medicare Advantage plans and Original Medicare options.
* Make your change during the open enrollment period to ensure smooth coverage transition.