Medicare: Open enrollment and upcoming changes

Medicare: Open enrollment and upcoming changes

By Nelva Hernandez, LCSW

Lower prescription drug costs are on the way for Medicare recipients. Several provisions of the Inflation Reduction Act of 2022 which President Biden signed into law in August of this year will mean Medicare beneficiaries will start seeing lower costs on many prescriptions in 2023.

Two exciting changes include lower costs for insulin and vaccines. Beneficiaries using insulin will pay no more than $35 for these prescriptions. All recipients will no longer pay co-insurance costs for recommended vaccines such as: COVID-19, influenza and Hepatitis B, making shots free or very low cost.

Other Medicare benefit changes coming in 2023:

• Medicare will continue to pay for immunosuppressive drugs beyond 36 months, if you don’t have other health coverage.

• Medicare beneficiaries who missed their initial enrollment and sign-up during the January to March general enrollment period will begin the following month rather than waiting until July.

In addition to these changes, insurance companies will also make changes to their coverage. Some companies will stop offering plans, increase or decrease the cost of their plans, change the medical coverage of their plans, change the cost of medications or even drop some medications from their drug coverage list.

Keeping up with Medicare changes can be a challenge but Medicare, like most other insurance plans, has an open enrollment period from Oct. 15 to Dec. 7, when beneficiaries can make changes to their plans. Medicare open enrollment period is also a great time to review how these changes affect you.

Alexandria’s Virginia Insurance and Counseling Program can help Alexandria City Medicare beneficiaries make sense of the changes by providing free, unbiased, personalized counseling. This program funded by the Administration of Community Living and Department of Aging and Rehabilitative Services helps beneficiaries understand their Medicare plans, options and compare plans so that our residents get the best coverage at the lowest cost.

In addition to prescription drug and Medicare plan comparison, the VICAP Program offers individualized counseling to help with a wide range of insurance-related issues such as understanding all parts of Medicare, Medicare Savings plans and Extra Help.

The open enrollment period is prime time for scammers. Beneficiaries are inundated with television ads, calls and mailings related to the open enrollment period. VICAP staff discourages providing any personal information to an unknown or unsolicited source. Scammers often target Medicare beneficiaries and victims may have coverage denied or benefits delayed.

To prevent Medicare fraud, screen calls, check Medicare Summary Notices to ensure it accurately lists services received and consult the provider about any unrecognized charges. Beneficiaries should also keep their Medicare card secure and keep careful records of conversations with plan representatives including representative names, the dates of the call and the information received. If there could be more than just a clerical error, please call the Alexandria City VICAP Program at 703- 746-5999 or Senior Medicare Patrol at 1800-938-8885.

The Alexandria VICAP Program has several options to help residents during open enrollment. The program will host several educational sessions to inform residents of the changes. In addition, residents have access to telephone counseling and the option to submit a request for plan comparison assistance. Trained volunteers receive the plan comparison request, create a plan analysis, mail it back to beneficiaries and follow up with beneficiaries whose insurance plan rates are expected to significantly increase the following year.

City of Alexandria residents can request a personalized benefit check by completing a Personal Information form at aging and submitting it online, or returning it by fax or mail.

The Alexandria City VICAP program is managed by the Division of Aging and Adult Services. For assistance or more information call 703-746-5999 or visit aging.

The writer is family services specialist III of the Division of Aging and Adult Services.