Medicare’s Fall Open Enrollment, officially known as the Annual Enrollment Period (AEP) is in full swing! It runs from October 15 – December 7, and is the time you can change your Medicare health plan and Part D coverage and/or return to Original Medicare. Coverage changes become effective January 1, 2023.
It’s an important time to review your coverage, and any health plan and Part D plan changes for 2023. Each year plans can change their premiums, out-of-pocket costs, drug formularies, network of covered providers and more, so it is good to see whether or not your current plan will still be a good fit for 2023. Contact your local Health Insurance Counseling and Advocacy Program (HICAP) for free counseling and information on your health care options in your area.
Note that in 2023:
- Medicare Part D will have some changes due to Inflation Reduction Act of 2022 (IRA). These include:
- Limiting insulin copayments to $35/month per prescription for covered insulin products in Medicare Part D plans starting January 1, 2023, and later for insulin received through durable medical equipment through Medicare Part B (such as insulin pumps) with no deductible, starting July 1, 2023;
- Eliminating cost-sharing for adult vaccines covered under Part D (i.e. shingles), even if the deductible hasn’t been met; and
- Requiring drug companies to pay rebates if prices rise faster than inflation.
- See the Center for Medicare and Medicaid Services’ summary timeline for changes due to IRA over the next several years.
- Medicare Advantage plans will continue to offer supplemental benefits in 2023 – With what started in 2020, MA plans can continue to offer new health and non-health related supplemental benefits in their plans. These benefits can be a bit misleading as they are not necessarily offered to all enrollees; they have specific eligibility criteria and limitations; and they could overlap with Medi-Cal benefits for dually eligible beneficiaries. Make sure to closely review plan member Handbook, as MA plans are required to clearly spell out the eligibility requirements for any supplemental benefits. See our past article for more info: Tips to Navigate Medicare Advantage Plans’ New Supplemental Benefits.
- Look for other options. If your health plan or drug plan is terminating its coverage, you should have received a notice by October 2 informing you of your rights and options for other coverage. See When Medicare Advantage Plans Terminate Coverage.
- Be on the alert. Agents and brokers selling Medicare Advantage and Part D plans must follow strict guidelines when marketing to you. Review our novella that shares what Medicare health plans and their agents CANNOT do in their plan marketing and provides savvy tips on how to protect yourself from enrollment fraud. It’s available in English and Spanish. Report any suspected marketing or enrollment fraud or abuse to our California Senior Medicare Patrol at 1-855-613-7080.
