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Medicare Open-Enrollment: Choosing the Right Plan

4.6

Clarence L. Polk

• November 06, 2023

If you find yourself with a barrage of Medicare open-enrollment questions and are unsure about which plan to choose before the Dec. 7 deadline, you may be tempted to brush it off and let it go. But according to Dr. Meena Seshamani, the deputy administrator and director of the Center for Medicare, that would not be wise. In a recent episode of the Podcast Name podcast, she emphasized the importance of starting early, asking questions, and evaluating your options to ensure that you make the best choice for yourself.

The Complexity of Medicare

In the podcast interview, Dr. Seshamani, who is not only a medical doctor but also a professor, addressed various inquiries concerning the Medicare program. These ranged from changes in Part D drug coverage to what working seniors need to know about their plan choices. However, given the overwhelming amount of information that seniors seek, it is nearly impossible to cover everything in a single session.

For additional information, Dr. Seshamani recommended Medicare enrollees to visit Medicare.gov or call 1-800-Medicare. Another helpful resource she mentioned is shiphelp.org. These platforms provide assistance and guidance for individuals who require personalized advice based on their medication usage or family situation. During the open-enrollment period, it is crucial that everyone finds the option that aligns with their unique story.

To listen to the full interview, click here. Due to the high number of questions from our readers, Dr. Seshamani couldn't answer all of them. However, we have compiled a few additional answers below:

Additional Answers

• Question 1

  • Answer 1

• Question 2

  • Answer 2

• Question 3

  • Answer 3

By taking the time to explore your options and seek guidance, you can make an informed decision regarding your Medicare plan. Don't underestimate the importance of this process. Start now and secure the best choice for your future healthcare needs.

Monthly Part B Premium Increase

Effective from Jan. 1, 2024, there will be a new pricing structure for Part B of Medicare. Part B covers regular doctor visits and other routine, non-hospital care. The monthly premium for 2024 will be $174.70, which is an increase of $9.80 from the previous year's $164.90. It is important to note that high-income seniors may be subject to additional surcharges referred to as IRMAA.

Using an HSA Account to Pay for Medicare Premium

One option to pay for your Medicare premium is to utilize a health savings account (HSA). With an HSA, you can use the funds saved to cover qualified medical expenses until you begin claiming Social Security. Once you start receiving Social Security benefits, the government will deduct the premium directly from your monthly benefit. However, it's essential to keep in mind that after enrolling in Medicare, you are no longer able to contribute new funds to your HSA.

Medicare Out-of-Pocket Maximum

While there are no statutory maximum out-of-pocket limits for Medicare Parts A and B, it's worth noting that Medicare Advantage and Medigap plans do have out-of-pocket limits. The specific limits will vary depending on the plan chosen.

Private Insurance vs. Medicare: What You Need to Know

If you're approaching the age of 65 and have private insurance through Healthcare.gov, you may be wondering if you can keep it without facing any penalties. Unfortunately, the answer is no. However, there are some factors to consider depending on your circumstances.

Workplace Insurance Plan

If you continue to work after turning 65, your workplace insurance plan may qualify as "creditable." In this case, you can keep your private insurance without penalty. However, once you're ready to retire, it's important to look into enrolling in Medicare.

Government Exchange Plan

If your health insurance plan is not through work but rather through the government exchange, you will need to enroll in Medicare. You can choose a Medicare Advantage or Medigap plan that best suits your needs.

Coverage Outside of the United States

It's essential to note that Medicare rarely provides coverage outside of the United States and its territories. This applies whether you're traveling abroad for a short period or living abroad for an extended duration. There are only a few exceptions outlined by Medicare:

1. The closest hospital to your home is in a foreign country.
2. You are traveling through Canada and experience a medical emergency.

More on Medicare:

• How to compare Medicare plans and choose the best one for you
• Overwhelmed by Medicare Advantage ads? You're not alone, but change may be coming.
• What's covered and what's not: A guide to enrolling in Medicare
• Confused about Medicare open enrollment? This program can provide assistance.