Medicare's fall open enrollment period ends Thursday.
During the annual seven-week period, which began Oct. 15 and ends Dec. 7, beneficiaries can make changes related to Medicare Part C (known as an Advantage Plan) and Part D (prescription drug coverage).
Medicare Advantage coverage is offered by private insurers under contract with the Centers for Medicare and Medicaid Services, the federal agencies that oversees these programs. These plans are offered in place of the original Medicare, which is comprised of Part A (in-patient coverage) and Part B (outpatient care).
Seniors with traditional Medicare also can buy supplemental prescription drug plans (Part D) through these companies. However, patients must have original Medicare and live in the plan’s service area in order to join an Advantage Plan.
Over the years, Advantage Plans have grown in popularity among Medicare recipients, according to a study by the Kaiser Family Foundation. In 2017, 33 percent of beneficiaries, or 19 million people, were enrolled compared to 13 percent in 2007. The highest enrollment growth — 71 percent — taking place since 2010 when the Affordable Care Act was passed, KFF found.
About 63 percent of Medicare Advantage enrollees have health maintenance organization (HMOs) plans and 33 percent are enrolled in preferred provider organization (PPOs) plan, according to Kaiser. The remainder are enrolled in private plans.
HMOs provide coverage to doctors, other medical providers and hospitals that are in the plan's network. This means an HMO typically will cover or reimburse medical costs incurred outside its network except in an urgent or emergency situation, according to Healthcare.gov. Enrollees also could need a referral from their primary-care doctor to see other physicians or specialists.
"It's really about how people want to manage their health care," Josh Norris, senior health insurance agent for Comprehensive Financial Consultants in Indiana told CNBC. "Some people want to visit whatever doctor they want, but for other people it doesn't matter as much."
A PPO costs more monthly and lets patients go to out-of-network providers. However, patients typically pay more in co-pays or co-insurance for that flexibility.
Premium costs for most Medicare Advantage recipients will average $30 a month in 2018, which is two dollars less than in 2017, according to the Centers for Medicare and Medicaid Services. The average premium for Part D will go down by $1.20 to about $33.50 a month, the CMS estimates.
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The average Medicare Part B premium will be about $134 a month for beneficiaries who make less than $85,000 ($170,000 for joint filing). About 28 percent of Part B enrollees will pay less — about $109 — than the full monthly premium of $134, because the increase in their Social Security benefit will not be large enough to cover the full Part B premium increase, the CMS reported.
But the premium costs for many high earners is slated to rise in 2018. Individuals earning between $133,001 and $160,000 ($267,000 and $320,000 for married couples filing jointly), for example, Part B premiums will jump by $80 a month, according to CMS estimates.
Beneficiaries who are signing up for Medicare for the first time have a window that starts three months before the month in which they turn 65 and ends three months after. To enroll visit the Social Security site's Medicare Benefits page here.
The federal government has extended the last day of open enrollment from Dec. 7 to Dec. 31 for those living in designated disaster areas nationwide.
People affected by hurricanes Harvey, Irma, Maria and Nate, and the California wildfires, qualify for this assistance.
Those eligible may need to provide proof of residency, such as a driver’s license or utility bill. To sign up, or find out if you are eligible for other disaster-related assistance such as extending a premium payment grace period, contact Medicare at 800-633-4227.