5 Facts about Medicare Open Enrollment

October 21, 2024

It’s time for millions of older Pennsylvanians to consider their coverage options during Medicare’s open enrollment period.

In Pennsylvania, beneficiaries can get free counseling via Pennsylvania Medicare Education and Decision Insight (PA MEDI), which is available at Pennsylvania’s 52 Area Agencies on Aging. Through the program, beneficiaries can get help from counselors about plan comparisons, enrollment, and eligibility for any of Pennsylvania’s Medicare cost-savings programs.

“If an older adult hasn’t reviewed their Medicare plan in recent years, now may be the time to check in,” Susan Neff, PA MEDI director, said in a statement. “PA MEDI can help older adults compare all aspects of Medicare Advantage and Prescription Drug plans by looking at overall costs, provider networks, supplemental benefits, prior authorization requirements, and drug formularies.”

Here are five things to know:

• Timing:  Every year, Medicare open enrollment is from October 15–December 7.
• Why it matters:  Coverage for health and drug plans change every year; it is important to review cost, coverage, and providers and pharmacies networks within your plan.
  • Take note of Evidence of Coverage and Annual Notice of Change letters.
• New this year:  All Medicare plans will include a $2,000 cap on what beneficiaries pay out of pocket for covered prescription drugs.
• Changing trends:  This year, about 57 percent of Medicare beneficiaries in Pennsylvania had a Medicare advantage plan, according to the Kaiser Family Foundation (KFF). A decade ago, about 42 percent of beneficiaries had Medicare Advantage.
• Noteworthy:  During 2022, nearly 70 percent of Medicare beneficiaries did not compare their Medicare coverage with other Medicare options during open enrollment.
  • Enrollees in traditional Medicare were more likely to skip shopping around than those in Medicare Advantage plans (73% vs. 65%), per the KFF. 

Additional information about this year’s open enrollment period is available online. Those who need assistance selecting coverage can also call 1-800-MEDICARE.