From now until December 7th.

Folks 65 and older, many of them are reviewing their health care options under Medicare and making some changes if necessary.

Medicare enrollment can be a confusing and complicated process, and weighing all the different coverage plans against your health care needs is no small task.

I talked with a Medicare expert with KFF, formerly the Kaiser Family Foundation in Washington, D.C., about the changes this year and watch seniors should watch out for.

And as you well know, many people in their 60s are still working and plan on working for several years.

So if you are age 65, the age of eligibility and you're still working and you have private insurance options, must you enroll in Medicare?

No.

You must.

There's you can delay enrollment in Medicare.

You sign up for part A, but part is premium free.

So you go to Social Security, you say, yes, I'm signing up for part A, but I do not.

One part B, I do not want to pay the part B premium because I have employer sponsored coverage either on my own or from a spouse.

Right.

And when you say part A and part B, a working definition of both of those, that's okay.

Yeah.

Yeah.

So Medicare has parts.

And part A is the part that pays for in hospital care or inpatient services.

Part B is the part of the program that pays for physician services, outpatient hospital services, diagnostic tests, things like that.

And so they're just different ways of signing up for the program.

There also is a part D of the program just to make things a little bit more complicated, which is the prescription drug portion of the program.

And when people come on Medicare and they need prescription drug coverage, they also they sign up for parts A, part B, and also part D. And all of those parts are optional.

Not really in the sense that, for example, with part B, it is a voluntary program, but there is a penalty for delayed enrollment.

And the reason that the law was created that way is an insurance program can't really work if people wait until they get sick to sign up.

So and so the idea is that when you're first eligible and you no longer have employer sponsored coverage, that's the time to sign up rather than to go periods of being uninsured for services that are covered under part B, like physician services, and then sign up later.

So it's it's kind of voluntary, but it's quite scary.

And the same is true for the drug benefit.

It's the same principle.

So for people who no longer have employer sponsored drug coverage, the idea is people with Medicare need prescription drug coverage.

And they and there's it is voluntary, but there is a penalty for people who say, I'm going to skip a few years because I don't take expensive drugs and sign up when I really need it.

So let's talk about some changes that are happening with Medicare.

What should beneficiaries know about increases or even decreases in their monthly insurance premiums?

Okay, this is the time that we are now in the middle of the open enrollment period.

It started October 15th and it runs through December 7th.

This is the time for people to review all their options and decide whether they want to keep the coverage they have or make a change.

And I'm just going to say upfront, it's not an easy decision, but it is an important decision.

And there are some some changes that you really can't affect.

For example, everybody on Medicare is responsible for the Medicare Part B premium.

And for most people, that's deducted from their Social Security check that will go up, between 2025 and 2026.

And it kind of is what it is.

There's not much anyone can do about that.

But for people on Medicare who choose Medicare Advantage plans, and I can talk about what they are or Medicare drug plan, those plans change from year to year.

Premiums may go up.

Some premiums may go down.

But there are a number of things that change.

And so this is really the important time to look at what's changing, what's not, what really matters in making this decision.

So people are blindsided when they, you know, start the new year and they find out something in their plan has changed.

So let's go back to where you were, Tricia.

What is a Medicare advantage plan?

And what should beneficiaries think about in choosing between traditional Medicare versus Medicare Advantage?

That is a great question.

And a lot of people struggle with this decision.

So when people think of Medicare, they may think of the national Medicare program, that, you know, you go to the doctor, Medicare pays its share, you pay your share.

Same with the hospital and other services.

That's that has been what Medicare has looked like for many years.

But over time, there has been a growing segment of the Medicare program called Medicare Advantage, which are really HMOs and PPOs that receive a payment from the federal government from Medicare to provide all Medicare services.

So if you're at home and it's during the open enrollment period, you're probably going to see a lot of ads for Medicare Advantage.

And this is an alternative to the traditional fee for service program.

Are there fewer options for 2026 because of changes, or does that stay the same?

There has there been a number of news reports about insurers dropping out of the Medicare Advantage program?

We are seeing that, by and large, insurers are still very much in the Medicare Advantage program.

Some are pulling out of some markets, but some are expanding into other markets.

Most people around the country will have a choice of dozens of plans available to them.

And while there may be some markets where there are few, if any, Medicare Advantage plans, the good news for people who are living in those areas is they're not going to risk being uninsured.

They always have regular Medicare there.

As a backstop.

And so that's a really important sort of safety net for people who may be concerned that the plans are pulling out.

But what we are we are not seeing a mass exodus of Medicare Advantage insurers this year.