Reviewing insurance coverage can be tedious and confusing. However, it’s one of those things you should do every year — even if you’re already enrolled in Medicare. Since there are some changes to Medicare, you might want to make changes to your coverage.
Seniors and qualifying individuals can enroll or adjust their Medicare coverage from October 15, 2022 to December 7, 2022. While the enrollment window is the same as in past years, there are five notable changes to keep in mind. These changes could make a big difference in the lives of some beneficiaries. Keep reading to learn more!
What Is Medicare?
Medicare is a federal health insurance program that offers coverage to seniors and qualifying younger people to help cover medical expenses. It’s important to keep in mind that Medicare isn’t completely free. In fact, many beneficiaries pay a monthly premium and have deductibles.
Traditionally, it also doesn’t include dental, hearing, or vision care. That said, Medicare is a very popular federal program. According to SingleCare, 18.5% of Americans are enrolled in Medicare. To put it another way, 61 million people in the U.S. are covered by Medicare.
GettyMedicare Eligibility
Even though a lot of Americans get health insurance coverage through Medicare, eligibility is somewhat restrictive. It’s designed to cover seniors aged 65 or older. However, coverage is limited to U.S. citizens and legal permanent residents who’ve established residency for at least five consecutive years.
While Medicare is designed with senior citizens in mind, it also covers some younger U.S. residents. According to the Center for Medicare Advocacy, Medicare is available to younger Americans who’ve “received Social Security Disability benefits for 24 months or have End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS).”
GettyHow Are Medicare Parts A, B, C, and D Different?
There are four distinct parts of Medicare coverage that each cover different medical services. AARP says many people don’t need to pay a premium for Part A, but Parts B, C, and D generally have premiums. Here’s a brief breakdown of the four parts:
- Part A: Since this part helps cover inpatient hospital care, it’s often called hospital insurance. It can help cover costs associated with hospital stays, nursing care, and hospice.
- Part B: This part is often called medical insurance because it covers things like outpatient care, doctor appointments, lab tests, and medical equipment.
- Part C: Original Medicare doesn’t cover everything, so some people also enroll in a Medicare Advantage plan — also known as Part C. These are provided through private insurers and can include things like dental and vision care.
- Part D: Part D coverage is also offered through private insurers and covers some prescription drugs. For that reason, it’s often called drug coverage. Much like Part C, Part D is optional.
GettyKey Medicare Changes in 2023
Now that we’ve covered the basics of Medicare coverage, let’s take a look at the changes you should know about before open enrollment ends. Notably, the passage of the Inflation Reduction Act brings changes that may make a big difference in some people’s lives. Here are five key changes to Medicare coverage that begin on January 1, 2023:
- This is a big one — the Inflation Reduction Act caps the copay for insulin at $35 a month for Medicare beneficiaries with Part D plans.
- Medicare beneficiaries with End Stage Renal Disease can now continue to receive coverage for immunosuppressive drugs beyond 36 months after a kidney transplant.
- Instead of the standard enrollment window that lasts from October 15 to December 7, enrollment changes next year. Starting in 2023, Verywell Health says, “your initial enrollment period can happen in the three months ahead of turning 65, the month you turn 65, or the three months afterward.”
- Additionally, qualifying individuals who miss the enrollment deadline because of exceptional circumstances may be able to enroll with a special enrollment period.
- Certain medical services related to COVID-19 will continue to be covered by Medicare. These include vaccines, antibody tests, monoclonal antibody treatment, and home tests.
GettyChoosing the Right Coverage for Your Needs
Seniors over 65 and qualifying younger Americans have a 54-day window to enroll in Medicare for the first time or review their coverage. Open enrollment lasts from October 15 to December 7. And the choices you make during that period go into effect come January 2023.
Your coverage choices impact your finances and healthcare. So, it’s important to take your time and research available plans and coverage changes. Since Medicare can change yearly, it’s a good idea to do your due diligence every year. That way, you can get the most out of Medicare.
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