Medicare open enrollment: everything you need to know

HOW DO I PREPARE FOR OPEN ENROLLMENT DECISIONS? IF YOU HAVE ORIGINAL MEDICARE, most people buy a separate Part D plan to cover prescription drugs. A review of your Part D options every year

is important to make sure you have the best plan for the next year. First, review your annual notice of change. If you have Part D, your plan must send you a notice by the end of September

outlining revisions to your costs and coverage. Make sure your prescriptions remain covered and find out if your premiums and other out-of-pocket costs will rise. Next, review all Part D

options in your area. Use the Medicare Plan Finder to compare them. * Confirm the plan includes all your medications. They can change their list of covered drugs, called a formulary, from

year to year. If your drugs aren’t listed, they won’t be subject to the $2,000 spending cap. * Learn what you could pay in total — premiums plus out-of-pocket costs — for your medications. A

plan with low premiums may have higher total expenses if copayments, the fixed amount you spend for a prescription after you’ve met your deductible, are high. * Make sure your preferred

pharmacies are included. * Find out if your drugs have coverage requirements such as prior authorization and step therapy. IF YOU HAVE MEDICARE ADVANTAGE, this private insurance alternative 

to original Medicare, also known as Part C, bundles Parts A, B and usually D.   First, read your letter. Medicare Advantage plans send members an annual notice of change by the end of

September each year. It explains revisions in benefits, costs, covered drugs and provider networks that take effect Jan. 1. Next, compare Medicare Advantage plans in your area using the

Medicare Plan Finder. Learn details such as:   * Premiums and out-of-pocket costs for your typical medical care. * Covered drugs and how much you’ll pay for them. * Doctors, facilities and

other providers. Check the plan’s website or ask your doctors if they participate. * Extra charges for out-of-network providers or facilities. Some plans impose higher copayments if you

don’t use participants on their list. Others don’t cover out-of-network providers except for emergencies. * A plan’s out-of-pocket maximum. MA plans are required to limit your Part A and

Part B expenses, different from the $2,000 ceiling for prescription drugs. In 2024, the limit must be $8,850 or less for in-network services or $13,300 for the covered total of in-network

and out-of-network services. Some have lower limits. * Potential special provisions for chronic conditions. * The plan’s star ratings, which grade using several quality measures. * If the

plan offers other coverage, such as dental, hearing and vision care. [embedded content] VIDEO: Original Medicare vs. Medicare Advantage, What's the Difference? WHY SWITCH BETWEEN

ORIGINAL MEDICARE, MEDICARE ADVANTAGE? ORIGINAL MEDICARE TO MEDICARE ADVANTAGE. Medicare Advantage all-in-one plans for health care and prescriptions may intrigue you, but make sure your

providers participate. Otherwise, you may pay more or have no coverage outside the network. You’ll likely have to jump through additional hoops to get some of the care you want: Medicare

Advantage plans may require more prior authorization than original Medicare before covering some services, and you may need a referral from your doctor to see specialists. MEDICARE ADVANTAGE

TO ORIGINAL MEDICARE. If you switch back to original Medicare, you can use any participating provider and choose a stand-alone Part D plan. You’ll need to pay a separate premium for Part D.

And if you’re eligible, you can buy a Medicare supplement policy, or Medigap, to help with Medicare deductibles and copayments, also for a separate premium. Medigap isn’t part of annual

open enrollment. A policy can be bought at any time of the year. However, Medigap insurers in most states can reject you or charge more because of preexisting conditions if more than six

months have passed since you signed up for Medicare Part B — unless you qualify for a guaranteed issue period, such as changing your mind within 12 months of choosing Medicare Advantage for

the first time or moving out of your plan’s service area.