As the year comes to a close, Medicare beneficiaries have an important opportunity to review their coverage, make adjustments, and prepare for the year ahead. Whether you're enrolled in Original Medicare, a Medicare Advantage plan, or a standalone Part D prescription drug plan, understanding what actions to take at year-end can help you avoid unexpected costs and ensure that your health coverage meets your needs.
Each fall, Medicare plans send out an Annual Notice of Change outlining updates for the coming year. This document explains changes to monthly premiums, deductibles and copays, provider networks, drug formularies and any additional or benefits that have been removed. Even small adjustments may impact your out-of-pocket costs.
The end of the year marks the final chance to change your Medicare coverage for the upcoming year. During Open Enrollment, individuals were able to review their current plans, and make changes if necessary. Some of these options:
- Switch from Original Medicare to Medicare Advantage (or vice versa)
- Change Medicare Advantage plans
- Join, switch, or drop a Part D prescription drug plan
Changes made during this period take effect on January 1.
For individuals that did not make a change during the annual open enrollment you may still be able to do so. Individuals enrolled in the Elderly Pharmaceutical Insurance Coverage (EPIC) Program or the New York State’s Pharmaceutical Assistance Program (SPAP), can still make that change before the end of the year. You can join or switch a Medicare Part D plan or Medicare Advantage plan once per calendar year, using this Special Enrollment Period (SEP) instead of waiting for the usual open enrollment.
The Medicare Advantage Open Enrollment Period (MA OEP): For those already on a Medicare Advantage plan, each year from January 1st to March 31st, you can make a one-time change. You have the ability to switch to a different Medicare Advantage plan or go back to Original Medicare (with or without a stand-alone Part D plan). If you experience certain qualifying life events (move, lose other coverage, etc.), you may get a broader Special Enrollment Period (SEP), allowing plan changes mid-year.
Make Use of Your Remaining Benefits before December 31st. Consider taking advantage of any unused benefits such as the Annual wellness visit, Preventive screenings (mammogram, colorectal cancer screening, flu shot, etc.), Dental, vision, or hearing benefits (Medicare Advantage plans) and Over-the-counter (OTC) allowances, if included in your plan. Many of these benefits reset annually, so using them now may help you save money. If you are close to meeting your out-of-pocket limit (Medicare Advantage) or your deductible (Part D), year-end may be a good time to schedule additional care or refill prescriptions before amounts reset.
Watch out for Medicare Scams. The year-end is a common time for fraudulent calls or mail about Medicare. Please remember Medicare will never call to ask for personal or financial information. Staying vigilant helps protect your identity and your benefits.
In conclusion, the end of the year is the ideal moment for Medicare beneficiaries to evaluate coverage, understand upcoming changes, and take full advantage of available benefits. With a little planning now, you can enter the new year confident that your coverage supports both your health and your budget.
Great resources for Medicare assistance is 1-800-Medicare (1-800-633-4227), Medicare.gov or your local State Health Insurance Assistance Programs (SHIP). If you need any further assistance please reach out to the Office for Aging Services and NY Connects either by stopping at one of our office locations, via email at ccnyc@chqgov.com or by phone at 716-753-4582.
