September 19, 2023

It’s Time to Consider Updating Your Medicare Coverage This Open Enrollment

About Brookdale Senior Living

Brookdale Senior Living offers multiple care levels for seniors in more than 600 communities nationwide. Brookdale helps you find the right care plan for yourself or your loved one. With amenities such as transportation services, salons and private dining rooms and activities such as gardening, fitness classes and trivia nights Brookdale caters to a wide range of interests and needs.

a lightbox sign that says open enrollment

Health needs can change in an instant. As someone’s health needs change, so does their need for better Medicare coverage. Unfortunately, not reevaluating your coverage every year can be a costly mistake. In one study, more than 20% of seniors overspent by more

than $500 per year. Mistakes like these can be detrimental not only to your physical coverage, but also your financial health.

The last several years have seen significant updates to Medicare coverage. And the options seem to be endless: In 2023, the average beneficiary had close to 70 different Medicare private plan options, including 43 Medicare Advantage plans, according to data from KFF (formerly known as The Kaiser Family Foundation). Coverage has changed so much that there are two-thirds more plan options available than there were six years ago.

Medicare coverage is determined during an annual open enrollment period. The 2023 Medicare Open Enrollment Period (OEP) occurs between October 15 and December 7. This is a time to evaluate your coverage, compare costs, expand your plan and potentially save money for 2024. It’s important to keep in mind that some plan changes will alter premiums, out-of-pocket costs, medication access, and provider and pharmacy networks. Depending on your coverage, plans can vary in cost from hundreds to thousands of dollars per year.

But many seniors don’t look at their coverage every open enrollment season. In fact, among the 11.3 million Medicare Advantage enrollees in 2019, only 10% voluntarily switched plans during the open enrollment period for 2020.

It’s important to be aware of the changes to your Medicare coverage. Every open enrollment is an opportunity to improve your coverage — and help you save money. We’ve compiled the latest in Medicare coverage from 2023 to 2024 so you can feel confident in your decision this fall.

Original Medicare

As the most common form of Medicare coverage, original Medicare is issued by the federal government. This means you can use any doctor or hospital that takes Medicare, anywhere in the United States. Original Medicare covers most medically necessary services and supplies in hospitals, doctors’ offices and other healthcare facilities. One benefit of original Medicare is that in most cases, you don’t need a referral to see a specialist. Unfortunately, original Medicare does not include routine dental care. However, as reported by AARP, in 2023, the program will expand the “medically necessary” dental services it will cover when combined with other procedures.

There are two parts to original Medicare: Part A and Part B.

Part A: Hospital Insurance

Part A covers inpatient hospital stays, care in a skilled nursing center, hospice care and some home health care. Of course, as with most health plans, there are limitations, deductibles and coinsurance or other out-of-pocket costs associated with Part A. While many enrollees do not have to pay a monthly premium for Part A coverage because of their work history, enrollees are still responsible for their deductible should they be hospitalized.

One of the updates to Part A coverage in 2023 was associated with the deductible. According to AARP, for 2023, the Part A deductible is $1,600 per stay — an increase of $44 from 2022’s deductible. And for those required to pay a premium (dependent upon work history), the monthly premium also increased by $7 from 2022 to 2023, making the 2023 premium $506 per month. Copays for inpatient stays in hospitals and skilled nursing facilities also increased in 2023.

Part B: Medical Insurance

Part B covers doctors’ visits and services, most medically necessary equipment — including wheelchairs and walkers — mental healthcare, hospital outpatient services, diagnostic tests, some vaccines, some therapy and some preventive care. Unlike Part A, where you may or may not have to pay a monthly premium, enrollees in Part B are required to pay a monthly premium — including those with Medicare Advantage plans. In 2023, the standard monthly premium fell to $164.90, a $5.20 decrease from 2022. The Part B deductible also decreased to $226 in 2023, down from $233 in 2022. However, this March, it was projected that the monthly premium may increase again — this time by close to $10 — to $174.80 in 2024. This premium increase is driven by a new Alzheimer’s treatment, which recently came under Medicare coverage this July. If spending estimates are correct, the new drug, Leqembi®, will be the third-most costly drug covered by Medicare Part B.

There are two additional parts to Medicare: Part C and Part D.

Part C: Medicare Advantage

Medicare Advantage, otherwise known as Part C, is a Medicare plan that is administered by a private health insurance company. Medicare Advantage (MA) offers a privately managed alternative for your health and drug coverage. Unlike Parts A and B, MA plans may have lower out-of-pocket costs than original Medicare. MA plans also often include dental coverage. With MA, you can only use doctors and other providers who are in the plan’s network and service area, and you may need a referral to see a specialist. There are several MA plans to choose from: In 2023, the average Medicare beneficiary could choose from among 43 MA plans. This is more than double the number of plans that were available in 2018. Between 2022 and 2023, reports HealthPayerIntelligence, the average monthly MA premium grew by 50%. This is the second year in a row that premiums have increased. Despite this increase, the average premium was still low due to high enrollment in zero-dollar premium plans. Another trend that experts are seeing with MA is its continued growth. MA enrollment increased by 2.7 million beneficiaries in 2023, according to data gathered by Chartis. As of March 2023, 30.7 million beneficiaries were enrolled in an MA plan.

Part D: Drug Coverage

Part D covers pharmaceuticals and some vaccines. This coverage is optional and is offered to everyone with Medicare. If you have original Medicare only, you can choose a stand-alone Part D plan. Many MA plans also offer Part D coverage. Part D experienced some changes in 2023. This year, the out-of-pocket cost of insulin products was limited to no more than $35 per month in Part D plans, reports KFF. In addition, the government limit on deductibles for Part D plans increased in 2023 from $480 to $505. Also in 2023, all commercially available vaccines needed to prevent illness are covered under Medicare Part D.

This open enrollment season, Medicare will be able to negotiate medication prices with drugmakers, helping to improve their affordability. Thanks to the Inflation Reduction Act of 2022, changes to Part D will potentially lower prescription drug costs for enrollees. This July, the Centers for Medicare & Medicaid Services (CMS) announced that the average monthly premium for Part D prescription drug coverage is expected to fall by 99 cents in 2024.

In Part D, catastrophic coverage occurs when your drug spending has reached a certain level. This rate changes each year. In 2023, enrollees pay a $505 deductible and 25% of total drug costs up to the catastrophic threshold, and then 5% coinsurance. In the catastrophic phase, Medicare pays 80% of total drug costs, the plan pays 15% and the enrollee pays 5%. For 2024 coverage, out-of-pocket spending will be capped even more. Part D plans will pay 20% of total drug costs. The 5% coinsurance requirement for enrollees will be eliminated, which caps their out-of-pocket spending. And by 2025, enrollees’ out-of-pocket drug costs will be capped at $2,000.

At Brookdale, we want our current and future residents to feel confident in understanding Medicare coverage choices. If more information is needed on senior living options, contact a Brookdale representative today.