Updates on Medicare and the Exchange/Marketplace in 2023

Note: Many annual updates and decisions have deadlines, so we will return to the long COVID patient story in December.

Open registration takes place annually. From October 15th through December 7th, you can join, switch, or stop your Medicare Advantage Plan during the open enrollment period. Coverage will begin on January 1st only if claimed by December 7th. If you enrolled in a Medicare Advantage/MA plan during this period but change your mind, you can revert to Medicare or change to a different MA plan (January 1st and March 31st MA Plans). During the open registration period (think of this as a limited redo period), you can only switch once during this second “start over” registration period, with the following parameters:

• You cannot switch from your original Medicare to a Medicare Advantage Plan.
• You can’t join another Part D drug plan if you have original Medicare
• You can’t switch from one Part D drug plan to another if you have original Medicare

Tip to remember: Even if you move to a Medicare Advantage Plan, you still have to pay your Part B premiums every month. Additionally, remember that in all TV ads for “free services through Medicare Advantage,” MA plans are sold in separate coverage packages per county. Medicare/CMS will monitor all MA packages sold, including MA’s planned start of his new 2023 oversight of advertising on television. A lot of misinformation. (Approximately 4800 types of MA plans are sold nationwide). Oh!

Note: If your 2022 income is less than $18,600 ($25,000 for a couple), you may be able to save on monthly Medicare premiums and other out-of-pocket Medicare costs, including prescription drug costs. Please check if you are eligible. Visit the Medicare Savings Program.

great tools: MyMedicare.Gov – The “Medicare & You 2023” booklet includes all Medicare benefits and excellent descriptions (online or available on request) and a complete list of MA plans and Part D/Prescription drug plans sold in your county is included. post code.

Make a checklist of important steps to take each year when making planning decisions, including continuing your original Medicare.

• Thoroughly review all medications. Look at each drug plan within the selected MA plan. See each self-contained/individual Part D plan. This will be the most important step that must be taken each year. Medication coverage is subject to change – always! (Remember – Insulin!)
• Check in with your healthcare providers (hospitals, oxygen, pharmacies, all healthcare providers, dentists, ophthalmologists) to make sure they are still included in your MA plan. This must be done to avoid “freaking out” and leaving the network. You won’t know this unless you ask.

Over the past year, the Biden administration and Congress have taken actions, mostly related to premiums and subsidies, that will affect coverage in 2023. Offer included. Open enrollment for people buying health insurance through the Marketplace will begin on November 1st and will continue until January 15th in most states.

Key elements within the Marketplace:

• 4 out of 5 customers will be able to purchase plans at lower monthly premiums due to expanded Affordable Care Act coverage and additional subsidies as part of the Inflation Reduction Act .
• The average subscriber will have six to seven insurance plans to choose from in 2023.
• Monthly premium reductions are typically based on income and family size. There are variations due to federal and state plans.
• If you qualify for a reduced monthly premium, the deductibles and out-of-pocket amounts for the insurance plans offered may be higher. (Example: Silver plan $5100 annual deductible). Explore all options.

Great insurance option for small employers, self-employed, recently unemployed, recently moved without insurance, early retirees/pre-65s/medicare. This may be an option if you don’t qualify for Medicaid, especially in states with Medicaid Extended Coverage (Idaho). We have help – don’t go without insurance, take your options.go to yourhealthidaho.org For plans, the navigator assists and finds insurance coverage.

All past articles and training materials are available on the Patient Financial Navigator Foundation web page. PFNFinc.comThe Foundation is an Idaho-based family foundation founded in 2017. Please call 208-423-9036 for more information.

Do you have a healthcare buzz topic? Want to tell your LONG COVID story?send contact to [email protected].