Medicare Open Enrollment (Updated October 2024)

Medicare is a federal health insurance program for people 65 years of age or older and for some people younger than age 65 with certain disabilities or serious health conditions. While the program helps with the cost of some health care, it doesn’t cover the cost for all medical expenses. For more information, visit the Medicare website.

Beneficiaries have choices in how they access Medicare coverage. Original Medicare (Part A and Part B) covers some doctor and hospital care and related expenses, but the beneficiary will have a cost share for copays, coinsurance and deductibles. For more information on Original Medicare, visit its page on the Medicare website.

Those with Original Medicare can buy one of 10 Medicare Supplement Insurance (Medigap) policies from a private insurance company. Medigap covers some of the costs that Medicare does not, such as copayments, coinsurance, and deductibles. Medigap policies, while issued by a private insurer, are regulated by the federal government for consistency in coverage. For more information on Medigap policies, click here.

Another option is an HMO model. Medicare Advantage Plans (also referred to as Medicare PART C) where the beneficiary can buy a Medicare-approved plan from a private company that bundles Part A, Part B, and usually Part D (prescription drug coverage) into one plan. These plans are required to cover everything Original Medicare covers and often provide other benefits such as dental and vision. By signing on for a Medicare Advantage plan, the insured is assigning their Medicare Part A and Part B benefits to that plan and cannot use their Original Medicare for as long as they are enrolled in the Advantage Plan and may be limited to providers and facilities in that plan’s network. There are several types of Medicare Advantage Plans. For more information, click here.

To compare Original Medicare to Medicare Advantage plans, use the federal government’s comparison tool.

Medicare Part D is the drug/prescription coverage for people with Medicare. If a person delays signing up for Medicare Part D, there may be a premium penalty imposed unless the person meets certain criteria. There have been significant changes to the Medicare Part D coverage which began in 2023 that will affect benefits going forward. For additional details, click here.

Beneficiaries may be eligible for Extra Help or a Low Income Subsidy to help pay drug plan premiums depending on their income. For more information, click here.

They may be eligible for the Medicare Savings Program which pays the Parts A and B deductibles, copays and coinsurance. For more information, click here.

Medicare Open Enrollment for coverage starting January 1, 2025 began 15 October 2024 and runs through 7 December 2024.

There have been some significant changes to the program and beneficiaries renewing their current coverage or signing up for the first time have to read the fine print carefully. Enrollees should look through their Annual Notice of Change to learn what may be different for 2025 which could include reduced extra benefits (i.e., flex spending cards, hearing, vision and dental care being slashed), more out-of-pocket costs next year, particularly for medications in the form of deductibles for certain medications, plans being discontinued necessitating a consumer actively selecting a new plan. For those in the plans that were discontinued, if a new plan isn’t selected before the close of open enrollment on 7 December, they will revert back to Original Medicare and may need to select a Part D stand alone drug plan. The 2022 Inflation Reduction Acts’ most notable provision was an annual $2,000 limit on Medicare enrollees’ out-of-pocket prescription costs, which starts in January 2025.

For impartial assistance in selecting plans, call Georgia SHIP at: (866) 552-4464 option 4