During Medicare's annual open enrollment period, which runs through Dec. 7, you can shop for coverage that better fits your needs and perhaps save a bundle on health and prescription-drug plans.
New rules governing prescription-drug coverage, shifting out-of-pocket costs, Medigap changes for new enrollees and a slew of new benefits available in Medicare Advantage plans offered by private insurers are reshaping 2020 coverage options.
Medicare Plan Finder (www.medicare.gov/plan-compare), Medicare beneficiaries' primary tool for sizing up coverage options, has been completely redesigned. If you need help comparing plans, make an appointment with a state health insurance assistance program counselor or other Medicare counselor early (go to www.shiptacenter.org or call 877-839-2675).
During open enrollment, you can switch between two basic types of coverage: traditional government-run Medicare or a private Medicare Advantage plan. Traditional Medicare typically includes Part A hospital coverage and Part B for doctor visits and other outpatient services. You'll owe 20% co-insurance for Medicare-covered services after meeting your deductible.
There's no annual limit on out-of-pocket spending, but enrollees can buy a Medigap policy to help cover those costs. Traditional Medicare beneficiaries can see any doctor who accepts Medicare and don't need referrals to see specialists.
Medicare Advantage plans must provide the same benefits as traditional Medicare but may have different rules and restrictions. Most Advantage plans include drug coverage, and many offer vision, dental and other benefits. Out-of-pocket costs vary from plan to plan and are subject to an annual cap. Enrollees can't buy Medigap policies.
Typically, you'll have to stick with your plan's network of providers and will need referrals to see specialists.
When weighing these two options, remember that Advantage enrollees who later want to switch to traditional Medicare may hit a snag: With some limited exceptions, insurers in most states are only required to sell you a Medigap policy during the first six-month period when you are both 65 or older and enrolled in Part B. Beyond that period, you might be charged more for a Medigap policy based on your health conditions or denied Medigap coverage altogether.
Compare the drug coverage. Yes, the Part D coverage gap known as the doughnut hole is closing in 2020, but that's not an excuse to skip drug-plan shopping this fall. Enrollees can still face hefty out-of-pocket costs that vary significantly from plan to plan.
And people with high drug costs face an added challenge next year: The total out-of-pocket spending required to reach "catastrophic" coverage -- in which beneficiaries typically pay 5% of the cost of a drug -- jumps to $6,350, up from $5,100 in 2019.
Advantage plan shoppers, meanwhile, must wade through a torrent of changes. As of 2019, Advantage plans have added flexibility to cover adult day care, in-home assistance, and other services. More changes are coming in 2020, when Advantage plans can offer chronically ill enrollees non-health-related benefits. These include transportation for grocery shopping and services to address social needs, from marital counseling to park passes.