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Medicare Open Enrollment 2023 Guide
Our 2023 Medicare Open Enrollment Guide will walk you through sign-up dates, tips for choosing a plan, and more. Get the information you need today!
2023 coverage: Medicare enrollment dates at a glance
Beyond your initial opportunity to enroll in Medicare plans, the federal government provides other windows for enrollment and plan changes each year.
2023 Medicare coverage costs at a glance
Here's a quick guide to what Medicare beneficiaries can expect in 2022 for each type of Medicare coverage.
Avoid these costly mistakes during Medicare open enrollment
Today medicareresources.org released tips to help consumers avoid costly mistakes while evaluating and selecting coverage during Medicare open enrollment.
Do Medicare supplement plans include prescription drug coverage?
Modern Medigap plans do not include prescription drug benefits. Instead, Medicare offers prescription drug coverage under Part D. Medicare enrollees can get prescription coverage either by switching to a Medicare Advantage plan or by purchasing a stand-alone Medicare Part D plan (PDP) to go along with Original Medicare.
How do Medicare Savings Programs help with Medicare costs?
Medicare Savings Programs (MSP) can pay Medicare Part A and Part B premiums, deductibles, copays, and coinsurance for enrollees with limited income and limited assets.
What in-home care will Medicare cover?
The in-home care that Medicare will cover depends on the type of care involved, and whether it's truly medical in nature.
Dental coverage: What to expect from Medicare
For half a century, Medicare has provided comprehensive health insurance coverage to America's seniors. But dental coverage isn't included in Original Medicare or Medigap plans.
If you’re approaching Medicare eligibility, you’ve probably heard about the various private-coverage options that are available to replace or supplement Medicare. These plans are popular, but are they necessary?
If you shun private coverage, can you get by on Original Medicare without purchasing supplemental coverage (Medigap and Part D prescription coverage) or using a Medicare Advantage plan?
For many low-income Medicare beneficiaries, there’s no need for private supplemental coverage. Almost one in five Medicare beneficiaries are dual eligible for both Medicare and Medicaid.
>This includes Medicare enrollees (both Original Medicare and Medicare Advantage) who are eligible for full Medicaid as well as those who qualify for Medicare Savings Programs that help low-income seniors pay premiums and cost-sharing under Original Medicare.
For dual-eligible enrollees who qualify for full Medicaid, that coverage picks up where Medicare leaves off, covering coinsurance and deductibles, as well as services not covered at all by Medicare (such as dental, vision, and long-term care). For Medicare beneficiaries who qualify for Medicare Savings Programs but not full Medicaid, there are varying levels of assistance available depending on the enrollee’s income.
Those who receive the least assistance (Original Medicare premium assistance only, but no help with coinsurance or deductibles) might find a Medigap plan to be beneficial, but most Medicare Savings Program enrollees do not have additional coverage under a Medigap plan.
So for low-income Medicare beneficiaries, public programs are available to fill in the gaps in Medicare coverage. And 30% of Medicare beneficiaries receive employer or union-sponsored benefits that supplement Medicare. But what about the rest of the population?
Is Original Medicare enough coverage on its own? Most Medicare beneficiaries don’t think so: Only 19% of Original Medicare beneficiaries have no supplemental coverage (either from Medicaid, an employer-sponsored plan, or Medigap).
If you’ve got significant funds that you wouldn’t mind using to pay out-of-pocket expenses, you could get by with just Original Medicare. The main risks are the fact that it doesn’t have a cap on out-of-pocket costs, and it doesn’t cover outpatient prescription drugs (Medicare Part D covers prescriptions, but that’s a separate policy that enrollees buy as stand-alone coverage, unless they enroll in a Medicare Advantage plan that includes integrated Part D coverage).
Discuss your coverage options with a licensed Medicare advisor at 1-844-309-3504.
There are certainly people who contend that even though Original Medicare has no cap on out-of-pocket costs, it is still plenty of coverage – and for the average enrollee, that’s probably true. But the purpose of insurance is to protect us against significant losses.
Although most hospitalizations last less than a week, my father was hospitalized for 136 days in 2004. With a similar hospital stay using 2021 cost-sharing requirements, his Medicare Part A (inpatient) out-of-pocket without a Medigap plan would have been $1,484 for the first 60 days, $11,130 for the next 30 days (at $371/day), and $34,132 for the final 46 days (at $742/day), for a grand total of $46,746 — that would have been the amount he had to pay, after Medicare paid its share.
He recovered, and has been quite healthy ever since he got a kidney transplant in 2012. But even after his long inpatient stay, he needed dialysis for the next eight years. Medicare Part B currently pays an average of about $235 per treatment for hemodialysis. That’s the 80% that Medicare pays, and the patient is responsible for the other 20%.
Without supplemental insurance, that works out to a patient responsibility of about $60 per session. And standard dialysis treatment is about 13 sessions per month, meaning the patient would pay roughly $780 per month for dialysis alone – not counting any additional outpatient care that might be necessary.
So although it’s true that normal-length hospital stays, regular office visits, and the odd MRI would be affordable for most people with just Original Medicare, there are certainly medical conditions that would be difficult for the average person to finance without supplemental coverage.
If you never get seriously ill, and if you only ever need the occasional generic prescription, you’ll be fine with Original Medicare alone. But who among us can accurately predict whether or not a catastrophic medical condition will befall us at some point in the future?
Although Original Medicare provides a solid insurance base, the lack of prescription coverage or an out-of-pocket maximum can leave beneficiaries on shaky ground if they develop a significant medical condition. If you prefer to have a little more predictability in your health care costs, it’s wise to consider either a Medicare Advantage plan or Original Medicare supplemented with a Medigap policy and a Part D policy.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.