Personal Finance
Medicare open enrollment ends Dec. 7. These last-minute tips can help
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Older Americans have just a few days left to evaluate their Medicare coverage for next year.
Medicare’s annual open enrollment period for health plans and prescription drug coverage runs until Dec. 7. Experts say it’s worthwhile for Medicare’s 67.8 million beneficiaries to make sure they have the best coverage for their needs.
“Now is as good a time as any,” said Juliette Cubanski, deputy director of the program on Medicare policy at KFF, a provider of health policy research.
While many beneficiaries are comfortable with their plans and may be reluctant to change, it’s still a good idea to look at all the options that are available, she said.
“It’s possible that you could save money,” Cubanski said. For example, you may find a plan that offers lower cost sharing for expensive medications or offers better coverage or extra benefits, she said.
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Beneficiaries should start with Medicare.gov as they start to shop for plans, according to Philip Moeller, author of “Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs.”
Medicare.gov’s online plan finder can help provide an overview of the plans available in a beneficiary’s geographic area and the monthly premiums and specific costs associated with services provided through those plans, Cubanski said.
Trained counselors are also available to provide free Medicare advice in every state through the State Health Insurance Assistance Program, also known as SHIP.
To effectively compare plans, there are some helpful tips that are good to keep in mind, experts say.
Make sure you have access to preferred providers
Beneficiaries may choose to go with original Medicare — Parts A and B with the option to add Part D prescription drug coverage — or private Medicare Advantage plans.
With original Medicare, you can see any doctor in the country who accepts Medicare, so access is not an issue, Moeller said.
But with Medicare Advantage plans, there are provider networks that limit the choice of doctors and hospitals from which a beneficiary may choose, he said.
It’s best to check — not assume — that the doctors you want to see will be covered by your plan, Moeller said.
Call Medicare Advantage plans or medical providers directly to find out if they are still covered, as brochures can sometimes be outdated, Cubanski said.
Check if your prescription drugs are covered
U.S. President Joe Biden delivers remarks, during an event on Medicare drug price negotiations, in Prince George’s County, Maryland, U.S., August 15, 2024.
Ken Cedeno | Reuters
Starting in 2025, there’s a $2,000 annual out-of-pocket cap on prescription drug costs through Medicare Part D.
That change is due to the Inflation Reduction Act, a federal law enacted in 2022.
Consequently, insurance will pay more for about 8% of people who take expensive prescription medications, but they may look for ways to get their money back for the remaining 92%, Moeller said.
That may come in the form of higher co-pays or deductibles or less generous plan benefits.
“The details really matter this year for Part D plans,” Moeller said. “People should do their homework and make sure that their Part D plan still does what they wanted it to do.”
Medicare Advantage plans, on average, will see deductibles for prescription drug coverage increase next year. Typically, those have been around $50 per month on average, though next year that will go up to just over $200, according to Cubanski.
“People in Medicare Advantage on average, will be facing a higher deductible for drug coverage in 2025,” Cubanski said.
Pay attention to your out-of-pocket costs
Open enrollment provides an opportunity for beneficiaries to manage how much their overall out-of-pocket costs — including premiums, deductibles and coinsurance — may increase in 2025.
“Make sure that you have manageable out-of-pocket expenses for the year,” Moeller said.
With original Medicare, beneficiaries typically pay no premiums for Medicare Part A. However, in 2025, the standard monthly Part B premium will go up to $185 per month — a $10.30 increase from $174.70 this year. Annual deductibles for Medicare Part B will go up to $257 in 2025 — a $17 increase from the $240 annual deductible for 2024.
Notably, Medicare Part B typically only covers 80% of expenses for doctors and outpatient costs, which can take a financial toll on beneficiaries, Moeller said. To help defray those costs Medicare doesn’t fully pay for, most people get a Medigap plan, he said.
Medigap, also known as Medicare supplement insurance, provides private insurance to help pay for out-of-pocket costs not covered under original Medicare plans. Average monthly Medigap premiums are $217, according to a recent KFF analysis, though those rates vary by state.
With Medicare Advantage, costs may vary from plan to plan, Moeller said, and you may pay more to see a doctor who is out of network.
Medicare Advantage enrollees face an average out-of-pocket limit of $4,882 for in-network services, according to KFF, or $8,707 for both in-network and out-of-network services.
Bottom line: “Details matter,” Moeller said.
Medicare original vs. Advantage: Choice is personal
Medicare Advantage has received its share of criticism, particularly for restricted access to care and unexpected costs some beneficiaries have encountered.
But experts say the choice between private Medicare Advantage plans and government Medicare original plans is largely personal.
“For some people, Medicare Advantage might be the right call,” Moeller said.
Medicare Advantage has certain upsides. It’s generally cheaper for consumers than traditional Medicare with a Medigap plan, Moeller said. It generally provides out of pocket protection against catastrophic health bills. It may also provide supplemental coverage for hearing, vision and dental, while traditional Medicare does not, he said.
However, Medicare Advantage enrollees may need to get prior authorization before receiving certain types of care, Cubanski said. In contrast, traditional Medicare generally does not use prior authorization.
You may still be able to make changes after Dec. 7
A senior citizen holds a sign during a rally to protect federal health programs at the 8th Annual Healthy Living Festival on July 15, 2011 in Oakland, California.
Justin Sullivan | Getty Images
In some cases, beneficiaries may still be able to make changes after the official Dec. 7 end of Medicare open enrollment.
“Dec. 7 is important, but it’s not the end-all date, in case you need to make some changes,” Moeller said.
Medicare Advantage has its own special open enrollment period that will start on Jan. 1 and last through the first quarter. During that time, Medicare Advantage beneficiaries may switch to a different Medicare Advantage plan, opt for original Medicare or enroll in a standalone Part D drug plan.
Alternatively, if you have had a life-changing event, such as a move, you may qualify to take advantage of Medicare’s special enrollment periods.
Moreover, people who live in areas that were affected by hurricanes or wildfires in 2024 may have more time to sign up for their 2025 coverage, according to KFF.
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Oxford University Press may have crowned “brain rot” the word of the year, but “dynamic pricing” was also a top contender.
Originally coined by economists in the late 1920s, dynamic pricing refers to “the practice of varying the price for a product or service to reflect changing market conditions. In particular, the charging of a higher price at a time of greater demand,” the publishing house said on its site.
Many people associate it with shifting airline ticket prices or how ride-hailing service Uber adjusts fares at busy times. However, there was heightened awareness — and controversy — around the practice in 2024, especially when it came to buying highly sought-after event tickets.
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“In some high-profile cases, dynamic pricing was used in setting prices for concert tickets, resulting in fans (often reluctantly) paying very high prices to see their favourite artists. In some cases, fans were in a virtual queue for hours before realizing how much they would be asked to pay, leading to questions about the transparency of dynamic pricing practices, as well as value for money,” Oxford said.
How and when artists use dynamic pricing
Ticketmaster is under investigation in the U.K. for its recent use of dynamic pricing in sales of next year’s reunion concerts from Britpop band Oasis.
Many Oasis fans took to social media to complain that they ended up paying more than double the face value of the ticket without warning. The band said it would abandon the practice for the North American leg of its tour.
Taylor Swift performs at Scottish Gas Murrayfield Stadium on June 07, 2024 in Edinburgh, Scotland. Swift’s Eras World Tour plays 15 dates across Scotland, Wales and England in June and August.
Gareth Cattermole/tas24 | Getty Images Entertainment | Getty Images
Taylor Swift reportedly refused to dynamically price her Eras Tour tickets because “she didn’t want to do that to her fans,” Jay Marciano, chairman and CEO of AEG Presents, which promoted the event, told HITS Daily Double in October.
Also in an interview this fall, Robert Smith, the lead vocalist and guitarist for the Cure, said dynamic pricing is “driven by greed,” calling the practice a “scam.”
How and when dynamic pricing is used is at the discretion of the artist or management, according to Andrew Mall, an associate professor of music at Northeastern University — and it was often determined under the radar.
However, with so many recent high-profile tours, “for sure, dynamic pricing has surged to the forefront of concert goers’ attention,” he said.
‘A capitalist inevitability’
“We all know that if you are looking for an Uber or Lyft, there are certain times of night when it’s more expensive. The market seems to have adapted to that,” said Joe Bennett, a forensic musicologist at Berklee College of Music. “But concert tickets were generally a fixed price.”
Slowly, however, a change was taking hold.
Throughout the 21st century, revenue from recorded music has gone down while revenue from live music events has gone up. By the mid-2000s, concerts “provided a larger source of income for performers than record sales or publishing royalties,” economist Alan Krueger wrote in a paper on the economic issues and trends in the rock and roll industry. Live music industry revenue jumped 25% in 2023 alone, according to data from Statista.
In 2011, Ticketmaster first introduced an early version of dynamic ticket pricing, which is now the standard for live music ticketing sales. In more recent years, “ticket sales went crazy” driven by post-pandemic pent-up demand and a surge in mega-star stadium tours, Bennett said.
“You can see why it’s tempting,” he said. “The live music industry is constantly leaving money on the table that fans would pay. Dynamic pricing is sort of a capitalist inevitability given the forces at play, but I don’t want to live in a world where it costs a $1,000 for my daughter to see Taylor Swift.”
Still, it’s now common for ticket-selling platforms to charge more per ticket depending on demand for the event at any given time — whether consumers like it or not.
“It’s not very popular, as you might imagine,” said Matt Schulz, LendingTree’s chief credit analyst. “Businesses and musicians are trying to see what the market will bear, and it makes things really difficult for the consumer.”
Chalk it up to ‘funflation’
Despite complaints, consumers prove that they have a high tolerance for the increasing price tags of live events, also known as “funflation.” Younger adults, particularly Generation Z and millennials, have demonstrated they would even go into debt to pursue some of these experiences, recent reports show.
Nearly two out of five Gen Z and millennial travelers have spent up to $5,000 on tickets alone for destination live events, one recent study from Bread Financial found.
“Knowing your limits is important,” Schulz said. “As much as you might love your favorite musician, there should be a limit to how much debt you are willing to go into for them.”
Why dynamic pricing won’t go away
“Consumers don’t like the idea of dynamic pricing, but there is a renewed ‘YOLO’ [you only live once] attitude over the past few years since the pandemic and, increasingly, that drives a devil-may-care approach when it comes to spending on discretionary experiences,” said Greg McBride, chief financial analyst at Bankrate.com.
Even with household budgets strained, “you get to a point where there are just some experiences where consumers draw the line and say, that’s not something I’m willing to give up,” he said.
Ticket sellers are well aware of this mentality, too.
“Our research consistently tells us that concerts are a top priority for discretionary spending, and one of the last experiences fans will cut back on,” Live Nation said in a quarterly earnings call in 2023.
But as consumers continue to spare no expense to see their favorite artist or group, that means that means dynamic pricing is here to stay, at least for now.
“The live music sector has been leaning into this attitude for a long time,” Northeastern University’s Mall said.
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