With less than a week to go until the close of Medicare Annual Enrollment Period (AEP) on December 7, Medicare beneficiaries are still reviewing their Medicare options for the 2022 plan year, according to a national Medicare survey by HealthInsurance.com.
The HealthInsurance.com Medicare AEP survey reached 1,000 Medicare-eligible Americans ages 65 and up, asking them their opinions of their current Medicare plans and coverage, along with healthcare costs concerns including accessibility to medical devices like hearing aids.
The survey revealed that 63% review their Medicare coverage on an annual basis. And 33% of those surveyed think there is a better Medicare plan than the one they are currently enrolled in, which may be why 22% intend to make a change to their current Medicare plan during AEP. Additionally, 42% of those changing their plans during AEP intend to increase their coverage, while an additional 42% are wanting plans with lower costs.
In terms of plan type, our survey found that 33% are considering switching from Original Medicare to Medicare Advantage; 33% are considering changing from one Medicare Advantage plan to another; and 20% are considering changing their prescription plan.
Cost is playing a big role in the decision-making process for many Medicare beneficiaries. Of those on Medicare, 89% think prescription drug prices are too high, 64% are worried about out-of-pocket medical costs, and 39% admit to not filling a prescription because it was too expensive. So it's no surprise that 84% of our Medicare-eligible survey respondents are taking advantage of "senior discounts" to help curb healthcare costs.
Accessibility emerged as a theme for this survey, too: 68% said that hearing aids should be sold over the counter, and 44% said they have or know someone who has avoided getting a hearing aid because of the cost.
Though choosing the right Medicare plan is an important decision, 59% still find it overwhelming or confusing to pick the best Medicare plan for their needs. In fact, 41% say understanding benefits is the most challenging part of finding the right Medicare plan.
Our HealthInsurance.com Medicare survey also gauged what's most important when it comes to choosing the Medicare plan. 34% said selecting a Medicare plan that accepts their doctors is most important, followed by plans with low premiums and copays (25%) or extra benefits like vision and dental (25%).
62% shop for Medicare plans online, which aligns with the 58% that do the majority of their research online to help understand their Medicare options.
Meanwhile, 37% contact their insurance agents to help them understand their Medicare options. And 22% turn to their family members or friends to help them navigate their Medicare plan options.
Click here to view the full HealthInsurance.com survey results and methodology.
The national survey of 1,000 Adults 65 or older was conducted by Scott Rasmussen on behalf of HealthInsurance.com using a mixed mode approach. Field work for the survey was conducted by RMG Research, Inc. Most respondents were contacted online or via text while 102 were contacted using automated phone polling techniques. Online respondents were selected from a list of Registered Voters and through a process of Random Digital Engagement. Certain quotas were applied, and the sample was lightly weighted by geography, gender, race, education, and political party to reasonably reflect the 65+ population. Margin of Sampling Error: +/- 3.1 percentage points (for full sample).
While many people don’t worry too much about the flu, the truth is that it can be a very serious illness, particularly for those over age 65. Seniors are more likely to experience serious complications from the flu, such as pneumonia, which can lead to hospitalization. As a result, you may want to prioritize getting a flu shot each year to reduce your chances of getting sick. If you use Medicare as your primary insurance, you might wonder, “Does Medicare cover the cost of flu shots?” This guide will help you understand how Medicare covers flu shots and how much you might need to pay out of pocket. That way, you’ll know what to expect going into the next flu season. Does Medicare pay for flu shots? Is a flu shot covered under Medicare? The good news is that, yes, Medicare will cover your flu shot. Flu shots are considered important preventive care that can help you avoid getting seriously ill. Of course, Medicare doesn’t want you to get extremely sick, so they cover the flu shot each year. Does Original Medicare cover flu shots?Original Medicare covers an annual flu shot under Medicare Part B, which is medical insurance coverage. You can get one flu shot per flu season. However, can get additional flu shots if it’s shown to be medically necessary. You can get a flu shot in a variety of places, but in order to ensure maximum coverage, be sure to use a Medicare-enrolled provider. If you have Medicare Advantage, be sure to use a provider within the insurance plan’s network.How much does Medicare pay for flu shots?Now that you know the answer to “Does Medicare pay for a flu shot?” you might wonder how much you’ll have to pay to get this service. Fortunately, if you have Original Medicare and use a Medicare-enrolled provider, you’ll pay nothing out-of-pocket for your flu shot. Medicare Advantage plans also cover one flu shot per season in-full. However, you’ll need to make sure you go to a qualified health care provider that’s within your specific plan’s network in order to get the coverage you need.What type of flu shots does Medicare pay for?Because Medicare generally pays for one flu shot per flu season, you might wonder what type of flu shot you should ask for. The good news is that medical providers will automatically give you the approved flu shot for your age group.Older Americans, such as those on Medicare, will receive a high-dose flu shot. This helps ensure that your immune system creates a strong enough response to protect you from the flu during the season. Contact Us to Learn More About Medicare Benefits for Flu ShotsThe answer to “Does Medicare cover a flu shot” is yes. This shot can protect you from multiple strains of the flu and help you avoid serious health complications. It’s important to get your flu shot as soon as you can because you can catch this illness anytime, and strains vary from year to year. If you have more questions about how Medicare covers flu shots and preventive care, or you’d like to compare Medicare plans to get the right coverage for your needs, we’re here to help. Contact us today!
When planning ahead for your healthcare expenses and how they align with your Medicare coverage, it’s very important to stay informed on the changes to Medicare each year. Several aspects of Medicare - particularly related to out-of-pocket costs - can change on an annual basis. Beyond costs or plan changes, Congress also occasionally proposes and passes legislation that often impacts Medicare benefits. In this article, we’ll review the recent changes, including the 2023 Medicare costs and an overall look at the state of Medicare in 2023. 2023 Medicare Costs: An Overview The Medicare costs that change each year are: Part A deductiblePart A daily coinsurancePart B deductible Medicare Part A CostsThe changes to Part A costs include:Part A deductible - $1,600, an increase of $44 from 2022Part A daily coinsurance for hospital stays over 60 days - $400 per day, an increase of $19 per dayPart A daily coinsurance for hospital stays over 90 days - $800 per day, an increase of $22 per dayPart A daily coinsurance for skilled nursing facility stays longer than 20 days - up to 100 days $200, an increase of $5.50 per month Keep in mind that it is possible to pay the Part A deductible more than once in a year. This would only happen when you have multiple hospital stays in one year, and your stays are separated by more than 60 days. In this situation, you’d pay the Part A deductible each time.When you pay the Part A deductible, that gets you 60 days in the hospital and 20 days in a skilled nursing facility. If your stay goes beyond those times, you’ll have to pay the updated daily co-insurance amounts indicated above. Medicare Part B CostsThe Part B deductible for 2023 decreased to $226. It was $233 for 2022. You have to pay the Part B deductible each year before Medicare starts paying its portion of your outpatient care. Unlike the Part A deductible, you’ll only be required to pay the Part B deductible once per year.After you’ve met the Part B deductible, Medicare will pay the first 80% of the cost for your care; you’ll be responsible for the remaining 20%. Besides standard Part B coinsurance, you might encounter Part B excess charges, which can be as much as 15% of the Medicare-approved cost for your care.There were no changes to these coinsurance costs for 2023. How Much Will Medicare Premiums Increase in 2023? The standard Part B premium for 2023 is $164.90, which is a decrease of $5.20 per month. This decrease takes some of the sting out of last year’s increase, which was one of the largest in history. You may pay a higher premium for Medicare if you have incomes exceeding $97,000 (single filers) or $194,000 (married filing jointly).In addition to the costs for using your coverage, you’ll also have to consider the cost for getting your coverage. Most people don't have to pay a premium for Part A coverage (because it’s been pre-funded through payroll tax deductions), but you do have to pay a premium for Part B coverage. Medicare Part D Changes Another major component of your Medicare coverage is Medicare Part D, also known as Prescription Drug Plans (PDPs). Part D is offered by private insurance carriers with a Medicare contract - not offered by the federal Medicare program. There have been major changes to Part D in the past year as a result of the Inflation Reduction Act. Some of these changes won’t take effect until 2024 or later, but a few of them will be effective in 2023. The changes that will be applicable for 2023 include:Caps on the cost of certain insulinTaxes on excessive increases in the cost for prescription drugsLowering the cost of many vaccinations covered under Part DEach of these changes will have an impact on both standalone Part D Prescription Drug Plans (PDP) and Medicare Advantage Prescription Drug Plans (MAPD). New Caps On Insulin PricesThe Inflation Reduction Act has brought us the Insulin Savings Program, which was a temporary “test program” that began in 2020. The program is now permanent and mandatory. But previously, it was optional: Part D plans could choose to participate on a voluntary basis.The Inflation Reduction Act limits monthly cost sharing for covered insulin products to no more than $35 for Medicare beneficiaries, as long as the insulin is on the plans formulary. No deductible will apply to these insulin prescriptions. For 2023 and beyond, insulin prescriptions are capped at $35 for a one month supply. This price level stays the same throughout the year, even if you enter the coverage gap or “donut hole.” Excise Tax On Excessive Cost Increases Cost increases on prescription drugs, which are set by the manufacturers, will be subject to a new tax beginning in 2023. Medicare will use 2022 drug prices as a baseline and will investigate the prices for 2023 prescription drugs. If the increases from 2022 to 2023 are larger than the official rate of inflation, the manufacturer will pay a tax equal to 100% of the amount that the increase exceeded inflation for the year. Drug prices will be tracked each year in this way. The hope is that manufacturers will be less likely to increase prices aggressively since they won’t be able to keep any of the extra revenue that large cost increases used to bring them.While this new policy doesn’t directly reduce or limit the prices you pay through your drug plan, over time, it may allow for smaller copayments and coinsurance for your prescriptions. Reduced Vaccine Costs Under Part D The Inflation Reduction Act is also impacting how much you’ll pay for vaccinations under Part D. Prior to 2023, most non-essential vaccines were subject to cost-sharing, which meant that you had to pay a copayment or coinsurance for them. For example, the shingles vaccine was famously expensive. For 2023 and beyond, many Part D covered vaccines will be available at no cost. This brings the Part D vaccinations into alignment with the rules and cost structure for Part B vaccines (like the COVID-19 and flu shots). This includes the shingles shot, so protecting against this painful illness will be cheaper starting in 2023. There are still vaccines that you’ll have to pay for under Medicare, even after these recent changes. Vaccines that are needed to treat injuries or exposure to certain diseases may still require cost-sharing. General Enrollment Period (GEP) ChangesThe last major change to Medicare in 2023 relates to entering Medicare when you’ve missed your original enrollment window. Most people get to enter Medicare when they turn 65-years-old. In that case, you have a seven-month enrollment period known as your Initial Election Period (IEP) during which you can enroll. If you miss this chance, you have to enroll during the General Enrollment Period (GEP). GEP runs from January 1st to March 31st each year. Previously, if you enrolled during the GEP, your Medicare coverage wasn’t effective until July 1, which left you with a significant gap in your medical coverage.For 2023 and beyond, your coverage will be effective on the first day of the month after you sign up during the General Enrollment Period, eliminating the lengthy waiting period. Learn MoreIf you still have questions about 2023 Medicare costs and how they impact you, call 800-620-4519 to speak to one of our licensed insurance agents. You can also view our Medicare resources online:Compare Medicare plans: Visit our Medicare plan comparison tool.Learn about Medicare: View our Medicare Learning Center.Note: These 2023 Medicare costs and updates are courtesy of the Centers for Medicare & Medicaid Services (CMS). For more information, visit the CMS newsroom.
Researching your Medicare plan and understanding how to use your benefits wisely is key to maximizing your Medicare plan. But if you don't take the time to learn all that your current plan has to offer, or if you avoid comparing Medicare plans when it may be time to make a change, you could end up paying more money for your healthcare. To help you make an informed choice, we’ve put together this guide about 10 costly mistakes to avoid when picking a Medicare plan. Mistake #1: Using Doctors And Medications That Are Not Covered By Your Plan Medicare Advantage plans have formal networks of providers and lists of medications that are covered (called a formulary). If you see doctors who aren’t in-network, you’ll be paying more for your care than if you use in-network providers. While some PPO plans will allow you to see non-network providers, you’ll save the most money when you use in-network providers. In the same way, plans only provide coverage for medications that are on the formulary. If you use non-covered medications, you’ll end up paying full price for them. So if your current plan doesn’t work with your doctors and medications, you may want to consider making a change to your coverage a qualifying enrollment period. Our online guided Medicare enrollment tool also allows you to check and see if your doctor and drugs are covered in a Medicare Advantage plan. Mistake #2: Not Taking Advantage of Additional BenefitsOne of the reasons Medicare Advantage plans are increasingly popular is because they usually provide benefits that are not covered by Original Medicare. These kinds of benefits can include dental, vision, hearing, or prescription drug coverage.These benefits also may be included in your plan at no additional cost. If you don’t use them, you might be paying more than you need to for these services. In addition to the potential cost savings, these additional benefits are designed to help you live a healthier life. Mistake #3: Paying Cash For Your MedicationsIt can be tempting to pay cash for some of your less expensive medications. This is especially true when you look into any of the various prescription discount card programs that are currently available. However, it's wise to avoid paying for your medications if you're expected to reach the third coverage stage of the Medicare Part D drug program (often called the donut hole). Your drug plan tracks your spending, so if you pay cash for a prescription, it doesn’t count towards your official spending. This means that you might not be able to move out of the donut hole if you pay cash for some of your medications. Instead, consider using your plan even if you’ll pay more, if it means that you’ll move out of the donut hole faster. Mistake #4: Not Understanding Your Plan’s CostsWhile Medicare Advantage plans generally help to limit your healthcare costs, it’s important to remember that there are costs you’ll be expected to pay for your care. These costs are usually referred to as cost-sharing. Cost-sharing can include deductibles, copayments, and coinsurance. Besides these amounts, you’ll want to double check your plan’s Out-of-Pocket Maximum (OOPM), which is the most you could possibly spend in one year. Mistake #5: Choosing A Plan Based On Premiums AloneIt can be tempting to focus on the monthly premium you pay for your coverage, and not dig deeper into the costs you’ll pay to use your benefits. Pay particular attention to any deductible that you have to meet, as well as co-payments for services you’re likely to use. Besides these, consider your total costs in light of any costs for prescription drugs you take, too. Mistake #6: Not Checking To See If You Qualify For Financial AssistanceThere are a number of federal and state programs that are designed to help you pay for the cost of your health care. These can include Medicaid, Extra Help, Low Income Subsidy, and state pharmaceutical assistance programs. While there are income and asset limits for participation in some of these, you should apply for them if you think there is any chance that you could be eligible. Many times the limits are dependent on household size so you may qualify even if your income appears to exceed the limits. The upside is huge and there’s no downside to applying, so don’t miss out any potential for savings with these programs. Mistake #7: Not Considering Late Enrollment PenaltiesIt’s very important to consider the impact of late enrollment penalties, especially when you’re first entering Medicare. You can potentially be subject to enrollment penalties for both Part B and Part D. These penalties are assessed in the form of an additional monthly premium. Importantly, these penalties are generally permanent; once you’re subject to them, you’ll pay them for the rest of your life.If you’re already in Medicare, and you have avoided late enrollment penalties so far, just make sure that you continue to have Part D drug coverage, either from a Medicare Advantage Plan or a standalone Prescription Drug Plan.Mistake #8: Not Reviewing Changes In Your CircumstancesIt's important to review any changes in your circumstances on an annual basis. If you’ve been referred to a new specialist, prescribed a new medication, or diagnosed with a new medical condition, you might be better served by a different plan for the new year. So be sure to consider the impact these kinds of circumstances may have on your Medicare coverage. Mistake #9: Automatically Renewing Your Plan Each YearEach year, your plan will mail your Annual Notice of Change (ANOC) before the fall Annual Enrollment Period (AEP). The ANOC outlines changes in your plan benefits or costs for the upcoming year. Use this document, along with your plan’s overall Evidence of Coverage (EOC) to know how to use your benefits for this year.If you don’t make a change during AEP, you’ll automatically stay in your current plan. But plan benefits change from year to year, as do Medicare Advantage plan networks. So it's essential to review your coverage each year. Mistake #10: Not Working With A Licensed Insurance AgentAs you research the plans available in your area, consider working with a licensed insurance agent like one of our TogetherHealth agents. We work with a network of the nation’s major insurance carriers and can provide you with a variety of plan options to fit your healthcare needs, remain in-network with your doctors, and give you strategies to save money on prescription drugs. Get Help With MedicareIf you need more guidance, call 1-800-620-4519 (TTY 711) to speak to one of our licensed agents and get advice on how to avoid these 10 costly Medicare mistakes.