Critter Corner – Navigating Open Enrollment: Kaiser Family Foundation (KFF) Offers Three Helpful Resources

Dear Kiwi and Mango,

Medicare Open Enrollment is right around the corner. Are there some helpful, reliable resources I can use to help make decisions about coverage?

Thanks for your help!

Dee Tales
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Dear Dee,

Kaiser Family Foundation (KFF), an independent source for health policy research, polling, and news (no relationship to the Kaiser Permanente health care organization), recently released three reports to help seniors navigate Open Enrollment. Two involve research and a focus group study about the ads you see on TV and in print, and the other covers important details about this year’s Open Enrollment.

For the first resource, in advance of the open enrollment period starting on October 15, KFF reviewed more than 1,200 unique television ads that aired more than 643,000 times last year to examine these marketing strategies in-depth. This report helps you see what may be misleading in the ads. Hopefully, with the new rules in effect, as discussed in today’s Ask the Expert article, you will not be seeing too many misleading and confusing ads this year. Please see KFF’s report for more details.

The second resource is a report featuring research that involved focus groups of Medicare beneficiaries and Medicare plan shoppers, and provides an overview of the resources they used to find out about coverage options. Many of the participants said they relied on agents and brokers when making coverage decisions. Few used government resources, such as the Medicare Handbook or 1-800 Medicare, but those who did generally found them helpful. Most of the respondents said they did not trust the content of the ads on television, particularly those that marketed lots of “free” benefits.

The third resource answers key questions about the Medicare open enrollment period. It addresses topics such as what changes beneficiaries can make during open enrollment, how features of traditional Medicare compare to Medicare Advantage, and how supplemental coverage like Medigap plans or retiree health benefits factor into Medicare coverage decisions. These are a few highlights:

• The annual Medicare open enrollment period runs from October 15 to December 7 each year During this time, people with Medicare can review features of Medicare plans offered in their area and make changes to their coverage which go into effect on January 1 of the following year.
• During Medicare Open Enrollment, people with Medicare may choose to receive their Medicare benefits through traditional Medicare or through a Medicare Advantage plan, such as an HMO or PPO, administered by a private health insurer.
• There are other opportunities for Medicare beneficiaries to make coverage changes outside of the open enrollment period, in certain circumstances.
• Enrollment in Medigap or employee-sponsored plans and programs is not tied to the open enrollment period, though beneficiaries may wish to take them into account when considering their options for Medicare coverage.
• Medicare beneficiaries with modest incomes may qualify for assistance with Medicare premiums and out-of-pocket costs from the Medicare Savings Programs (MSP) and Part D Low-Income Subsidy (LIS) if their income and assets are below certain amounts.
• The average Medicare beneficiary can choose from 43 Medicare Advantage plans offered by nine insurance companies in 2023. These plans vary across many dimensions, including premiums and out-of-pocket spending, provider networks, extra benefits, prior authorization and referral requirements, and prescription drug coverage. As a result, enrollees face different out-of-pocket costs, access to providers and pharmacies, and coverage of nontraditional benefits (such as dental, vision, and hearing) based on the Medicare Advantage plan they choose.
• Traditional Medicare and Medicare Advantage both provide coverage of all services included in Medicare Part A and Part B, but certain features, such as out-of-pocket costs, provider networks, and access to extra benefits vary between these two types of Medicare coverage. People may prefer traditional Medicare if they want the broadest possible access to doctors, hospitals, rehabilitation facilities, and other health care providers. Traditional Medicare beneficiaries may see any provider that accepts Medicare.

For more information and details, please see “What to Know about the Medicare Open Enrollment Period and Medicare Coverage Options” report here.

Hope this helps!

Kiwi and Mango