How to Complete an Annual Medicare Check-Up

Between October 15th and December 7th, everyone enrolled in Medicare has the opportunity to protect their financial health for the coming year. I am talking about Medicare’s open enrollment window when current Medicare users have the ability to make changes to their coverage for the next year.

It makes me a little bit nuts that so few people take the time to review their coverage and make sure they have the best plan for the coming year.

Don’t tell me that you love your coverage and don’t want to change anything. That’s not the point! You need to realize that your coverage may have changed. A prescription drug that costs you $15 a month this year, might cost you double or triple that next year. Believe me, this sort of thing happens. Plans change their rules. It’s up to you to figure out if there’s a better (less expensive) plan to switch to.

On the Medicare website, there is a free tool you can use to compare your current plan with other plans offered in your region. At a minimum I want you to make sure your prescription drug costs are not going to be hit with big increases next year.

You need to be vigilant about drug costs. The big drug cost protection for Medicare enrollees that was passed in August as part of the Inflation Reduction Act delivers great news: It will cap Medicare prescription drug costs at $2,000 a year. But that $2,000 cap does not start until 2025.

You need to make sure you will be okay in 2023. Here’s how:

If you are enrolled in Original Medicare:

I sure hope you have a separate Part D Prescription Drug plan. It is not difficult to change your Part D plan, yet research shows that some people are paying hundreds of dollars more a year because they don’t take the time to review their current plan and move to a lower-cost option.

You can use the Medicare tool to compare the cost of your premium, deductible, and copays for prescriptions next year to other plans offered in your area. The tool will tell you about the actual out-of-pocket cost for specific drugs. If you find your current plan is raising the price of a drug you use, then you can check other plans there too.

If you are enrolled in Medicare Advantage (MA):

You likely do not have a separate prescription drug policy. The way it works with MA plans is that drug coverage is part of your overall plan. But I still want you to carefully review next year’s costs for the drugs you currently use. If you find there is a big increase, you have a bit of a headache to deal with. You can’t just switch your drug coverage; you will need to enroll in an entirely different MA plan. I know, I know, that sounds like a heavy lift. You will want to make sure that any plan you are moving to for better drug coverage also includes the doctors and facilities you like as in-network. But assuming another plan has a good roster of in-network doctors and facilities, if you can also save on your 2023 prescription drug costs, why wouldn’t you make the switch?

And even if you find that your MA drug plan remains a solid choice, I also encourage you to check in with any doctors you would be upset to lose access to. Ask if they will continue to be in-network in 2023. You want to know if anything is changing right now, when you can make a move too.