How to get the most out of Medicare open enrollment

Once you become eligible for Medicare, it plays a major role in your health coverage. Still, it is not something to leave untouched year after year. Each year gives you a chance to review your plan and make changes if needed.

The annual Medicare Open Enrollment window gives beneficiaries time to reassess their coverage and make sure it still matches their health care needs. Any changes made during this period generally begin on Jan. 1 of the next year.

Because both your health needs and Medicare plans can change over time, it is wise to check your options regularly. Insurance carriers may alter benefits and costs, or even stop offering certain plans. If you do nothing during open enrollment, you will usually stay in your current plan if it remains available. A yearly review can help you find a plan that better fits your situation or reduces your expenses.

There are several paths to choose from when selecting Medicare coverage:

Original Medicare (Parts A and B) includes hospital care and medical services such as physician visits. Part A generally has no monthly premium if you have worked for at least 10 years. Part B comes with a monthly premium, and higher-income beneficiaries may pay more based on income. It also includes an annual deductible and cost-sharing, with updated amounts typically announced in November for the coming year.

Medicare Advantage (Part C) is a private-insurance alternative to Original Medicare. Many of these plans combine Parts A and B, usually include Part D, and often add extras such as vision and dental benefits.

Medicare Part D offers standalone prescription drug coverage for people who stay with Original Medicare. Part D plans include a $2,400 annual cap on out-of-pocket costs for covered prescription drugs, although the list of covered medications differs from plan to plan.

Medicare Supplement (Medigap) policies are designed to help pay some of the out-of-pocket costs that Original Medicare does not cover.

When comparing plans, it helps to look closely at several key factors:

Out-of-pocket costs, including premiums, deductibles, copayments and other expenses Medicare does not pay.

Prescription drug coverage. Even with the $2,400 out-of-pocket cap for covered drugs, each Part D plan covers a different set of medications, so it is important to confirm that your prescriptions are included.

Provider access. Check that your doctors and hospitals are part of the plan’s network.

Your expected health care needs. If you anticipate ongoing treatment, specialist visits or planned procedures, make sure the plan offers the right level of coverage.

Travel considerations. People who travel often may want extra coverage for emergencies outside the United States.

Even if you are happy with your current plan, it should not be assumed that next year’s coverage will be identical. Premiums, provider networks and covered medications can all change from year to year, so a brief annual review is still worthwhile.

Do not let your Medicare coverage run without attention. Use the annual open enrollment period to help ensure your plan continues to meet your needs in the year ahead.