Understanding the Myths and Misconceptions Surrounding Medicare: 2023 Insider Tips and Information
This resource provides key Medicare data for 2022. It is important to note that while Medicare is a national program, coverage can vary by location, for example: a resident of Houston has 69 different Medicare Advantage plans, 29 different Medigap plans, and 21 different Medicare Part D plans to choose from.
Understanding Medicare
According to a 2021 Issues & Trends report from AAMSI, only 1 in 3 consumers have a good understanding of Medicare insurance. Additionally, a study from KFF in October 2020 found that 57% of beneficiaries do not review or compare their options annually, including 24% who never compare plans and 22% who rarely compare plans.
Saving on Drug Plan Coverage
The American Association for Medicare Supplement Insurance reported that consumers who switch drug plan coverage during Medicare's Annual Enrollment Period typically save between $550 and $750 per year.
Problems With Medicare Advantage Plans
A report from the U.S. Department of Health and Human Services' Office of Inspector General found that Medicare Advantage plans denied millions of requests for medical care, including tests and treatments that should have been approved and paid for.
Call Center Issues
In response to confusing and misleading ads featuring celebrity spokespeople, the Centers for Medicare & Medicaid Services will now require insurance agents who sell Medicare Advantage plans to record all phone calls with beneficiaries.
Choosing a Medicare Advantage Plan
On average, Medicare beneficiaries have 38 different Medicare Advantage plans to choose from, but in the top 25 counties where these plans are selected, individuals have between 60 and 80 plans to choose from, such as 69 in Houston and 71 in Los Angeles.
Dental Benefits in Medicare Advantage Plans
It is important for consumers to carefully compare what is included in the "free dental" benefits advertised by some Medicare Advantage plans as coverage can vary significantly. There may be annual limits on coverage, for example, $1,000, and some plans may only cover one cleaning per year while others cover two. Most plans do not cover implants, but some may cover up to $2,000. The average annual out-of-pocket limit on dental coverage was $1,300 in 2021, but more than half of enrollees were in a plan with a maximum benefit of $1,000 or less, with some having limits as low as $500.
Medigap Plan Pricing
Pricing for Medigap policies can also vary significantly, with the lowest monthly premium for a female age 65 in Houston being $121.18 and the highest being $226.42.
Medicare Drug Plan Pricing
The lowest Part D drug plan premium in Houston in 2022 was $6.90 per month according to the American Association for Medicare Supplement Insurance, while the highest was $154.90 per month.
2023 Medicare Annual Enrollment Period (AEP)
The Medicare Annual Enrollment Period (AEP), also known as Medicare Open Enrollment, is a time when millions of people can review their coverage to find better options or lower costs. From October 15 to December 7 each year, you can join, switch, or drop a plan. If you make a change, your new coverage will start on January 1, as long as the plan receives your request by December 7. If you do not take any action, your existing coverage will automatically renew for the next year.
During the AEP, you can make a variety of changes to your coverage without undergoing medical underwriting. You can switch from Original Medicare to Medicare Advantage or vice versa, change from your current Medicare Advantage plan to another, switch from your current Part D (Medicare prescription drug) plan to another, join a Medicare Part D plan (though a late-enrollment penalty may apply), or drop your Part D coverage altogether.
It is important for consumers to compare Medicare Advantage and Part D plans during each AEP. There are multiple online tools available to compare available drug plans.
