Medicare Open Enrollment 2023: Everything You Should Know

What Is Medicare?

Medicare is the federal government’s health insurance plan for those who fall into one of the following categories.

• People who are ages 65 and older
• People who are outside of that age group but who qualify due to a specific disability
• People who have end-stage renal disease, otherwise known as ESRD, which indicates permanent kidney failure that requires a transplant or dialysis

Medicare comes in different coverage parts, each of which covers specific services. These include:

• Medicare Part A (Hospital Insurance): Medicare Part A provides coverage for inpatient hospital treatment, skilled nursing facility treatment, some at-home healthcare services and hospice care.
• Medicare Part B (Medical Insurance): Medicare Part B provides coverage for specific doctors’ services, preventive services, medical supplies and outpatient care.
• Medicare Part D (prescription drug coverage): Medicare Part D provides coverage for the cost of prescriptions drugs, including many recommended vaccines and shots.

What about Medicare Part C? Medicare Part C is considered a Medicare Advantage Plan. It works similarly to a PPO or HMO, where you can choose a Medicare plan from a private insurance company that’s approved by Medicare.

These plans will provide coverage that’s typically included in Part A and Part B plans. Many also offer Part D prescription drug coverage. Medicare Part C plans may also offer extra coverage, for programs like vision, dental, hearing and wellness programs. Many people prefer Medicare Advantage Plans because they offer customization and control over the types of services you can get and from which providers.

Medicare Supplement Insurance (Medigap):

Medigap is Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like: Copayments, Coinsurance & Deductibles. A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

Medicare Terminology

You may see some abbreviations that relate to Medicare plans. One common one is MAPD vs PDP.

A PDP refers to a Medicare Part D plan, which only covers prescription drugs, which you can add to a Medicare Part A and Part B plan. MAPD refers to a Medicare Advantage Plan that includes prescription drug coverage, as well as Medicare Part A and Part B coverage. You can’t have both a PDP and a MAPD simultaneously.

Another common Medicare abbreviation is ANOC. This stands for Annual Notice of Change. Before the AEP, you should receive an ANOC from your current Medicare plan. provider, if you have one. The ANOC will cover any changes in cost and/or coverage that will go into effect in January.

Look closely at the ANOC, because you may determine that these changes cause you to want to also change your plan. For example, if you currently have Medicare Part A, B and D plans, but costs are going up or your preferred doctor will no longer be covered, you may want to talk with an insurance broker about a Medicare Advantage Plan that gives you the exact coverage you want.

What Changes Can You Make During the AEP?

You’ll want to consider your Medicare coverage every year, because the kind of coverage you’re interested in may be on a different carrier. For example, if you want to change a medication or use a new prescription drug, there may be drug and formulary tier changes with every AEP.

During the AEP, you can make the following changes to your Medicare coverage.

• Change from Original Medicare to a Medicare Advantage Plan.
• Transition from a Medicare Advantage Plan to Original Medicare.
• Change from one Medicare Advantage Plan to a different Medicare Advantage Plan.
• Get a Medicare Advantage Plan that provides prescription drug coverage.
• Change to a Medicare Advantage Plan that doesn’t provide prescription drug coverage.
• Join a Medicare Part D plan.
• Change from one Medicare Part D plan to a different Medicare Part D plan.
• Drop your Medicare Part D plan.

You can make as many changes as you want before the deadline. If you make a change during the AEP, you can also expect to get new Medicare ID cards that you can use once your new coverage goes into effect.

What If You Don’t Make the Medicare Deadline?

You may have other options to enroll in or change your Medicare coverage after the December 7 deadline, or before the AEP, depending on when you turn 65. You can apply for Medicare 3 months before and 3 months after the month of your 65^th birthday, as well as during the month of your 65^th birthday – so for a 7-month period altogether.

There are also qualifying life events that may enable you to sign up for or change your Medicare outside of the AEP. These include change in residence, involuntary loss of creditable drug coverage, gaining or losing Medicaid, losing employer coverage and etc. You normally have up to 3 months from the special enrollment period to elect a plan.

Learn More About Your Medicare Options

Health insurance is essential, especially during senior years. There’s a lot to consider and various deadlines to keep track of. Any time of year, you can connect with the AZ Health Insurance Brokers team to stay ahead of your Medicare enrolment deadlines and get answers to any health insurance questions you have.

You can also visit the Medicare.gov website to explore Medicare coverage options online and add your drug and pharmacy information to get personalized cost details. You can also read over the official U.S. government Medicare handbook, which has more than 125 pages of Medicare information.

Or, call AZ Health Insurance Brokers at 602.617.4107 any time you want a quick answer to one of your Medicare or health insurance questions. We’re here to help you get the coverage you need to ensure your health is protected.