It’s that MOST WONDERFUL time of the year again….Medicare Open Enrollment
Reminder: Medicare Open Enrollment Ends December 7
I am happy to introduce a guest blogger/author for this segment: Clara Morose
Are you 65 years and older without private insurance? Then Medicare may be the option for you. This time of year can be a confusing time for many older adults because finding the right Medicare plan can be like finding a needle in a haystack. Medicare open enrollment takes place between October 15th through December 7th and in that time, individuals are encouraged to shop around for different plans that will take care of future healthcare costs for the following year. Signing up for a plan may sound simple but the Medicare enrollment process can be quite confusing and often people the perception that the more expensive the plan the more aid they will receive for their health care costs. Yet, this is not always the case.
Medicare care covers different parts of your healthcare services. For example, Medicare Part A covers hospital stays, hospice care, skilled nursing facilities, and some home health care. Part B covers medical supplies, preventative services, and doctor services. Finally, Part D covers many vaccines as well as prescription costs at your local pharmacy. Once enrolled in Medicare Part A and Part B, individuals can select if they want to select a Medicare Advantage Plan that assists with health care costs and drug costs, or a Supplemental Health Plan plus a Medicare Part D plan for prescriptions.
Finding the right Medicare coverage can be overwhelming for you or as a caregiver. How do you know if this is the right plan for you? Will it help cover your doctors’ visits? Will I be able to afford my prescriptions? Here are some things to consider when trying to choose the right plan:
Costs – How much are premiums, deductibles, prescriptions, and a hospital stay?
Coverage – Does the plan cover medical services and supplies?
Prescription – Will the plan cover medications I take or medications I may need down the road?
Doctor, hospital, and pharmacy choice – Will your doctor’s office accept your coverage? Do you have to choose your doctors within network? Which hospital do I need to go to in need? Do I need to change pharmacies or is my current pharmacy preferred?
Other coverage – If you have other private coverage, make sure your other coverage works with Medicare (Some insurances cover individuals post-retirement and can be a simpler option.)
Quality of Care – Are you satisfied with the quality of care and services offered by your plan?
Travel- Do you need supplemental insurance to cover care outside of the US? Or outside your network?
Costs to consider when enrolling in Medicare Part D:
There are 4 coverage stages for Medicare prescription Drug Plans for 2022: To find out more information please visit
|Coverage Stage||Drug Costs||Payment Breakdown|
|Annual Deductible||$0-480||Member pays 100%|
|Initial Coverage||$4,430||Member pays 25%
Plan pays 75%
|Coverage Gap (Donut Hole)||$7,050||Member pays 25%, Plan/Manufacture pays 75%|
|Catastrophic Coverage||For the remainder of the year’s coverage||Member pays 5%,
Plan pays 15%,
Government pays 80%
Compare plans using the plan finder tool at https://www.medicare.gov .
If members or caregivers still have questions or need help with choosing or enrolling into a Medicare plan, the number to reach Medicare is 1-800-633-4227. And be certain to ask if you qualify for Extra Help through Social Security and if your state has a State Pharmacy Assistance Program to help reduce costs.
When reviewing plans, remember it’s also a great time to review medications and check for unnecessary medications. Use the templates in the template option to start the conversation with your health care team on deprescribing to optimize your medications. Sign up for more updates on deprescribing and managing medications below. Most of all stay WISE & WELL through this most Wonderful Time of the Year!