Medicare Open Enrollment: What’s New for 2018?

Tue, Nov 14, 2017 --


It’s that time of year again — time for your patients to start thinking about their healthcare needs and what they’re looking for in their Medicare health and drug plans. Medicare Open Enrollment began on Oct. 15 and will remain open until Dec. 7. And there’s good news. CMS reports more options and lower premiums in 2018, which means your patients should be able to find plans that cost them less and give them more.

This year’s lineup includes the addition of 400 Medicare Advantage plans from which your patients can choose, with greater than 85 percent of Medicare recipients having access to ten or more Advantage plans. Monthly premiums for the average Medicare Advantage will decrease by almost $2.00, reducing the average cost by about 6 percent. For the first time since 2012, the average basic monthly premium for the Medicare Prescription Drug Plan is expected to decrease by about $1.20.

Most areas nationwide will have access to Medicare Advantage and Part D plans rated four stars or higher. In 2018, approximately 73 percent of Medicare Advantage enrollees with prescription drug coverage will be in plans with four and five stars, compared to 69 percent in 2017. Forty-seven percent of persons enrolling in stand-alone prescription drug plans will benefit from four- and five-star-rated plans, compared to only 41 percent the previous year.

Selecting the Right Medicare Plan

You may want to remind your patients about open enrollment, particularly those becoming eligible for Medicare for the first time. With good news on the horizon, you can confidently encourage your patients to weigh their options.

If your patients choose to stay in their existing plans, chances are that they’ll be among the 77 percent whose premiums will either remain the same or cost less in 2018. Nevertheless, it’s wise to look at new plans to ensure they keep current with their evolving healthcare needs.

For coverage beginning on January 1, 2018, they can review and compare plans available in their area. You can refer them to CMS’ Medicare Plan Finder, which will allow them to search for and compare options to find the plan that best suits their needs.

Regardless of what Medicare plan your patients choose, they will receive:

  • A 65 percent discount on covered brand-name drugs if you reach the Part D prescription drug coverage gap
  • A free annual “wellness” visit
  • Preventive tests and screenings, most of which are provided free of charge

Bottom Line

Medicare has good things in store for 2018. But only your patients know their personal needs and the resources available to them. Encourage them to take the time they need to make the right decision — so long as they don’t take too long. The window closes on Dec. 7. If they miss open enrollment, they’ll have to wait until next year.

How About You?

Are you on top of Medicare changes affecting your practice? Stay abreast of recent updates and key issues with the Medicare Compliance & Reimbursement Alert or go in-depth on Part B news with Part B Insider.


Deborah concentrates on coding and compliance for radiology and cardiology, including the tricky world of interventional procedures, as well as oncology and hematology. Since joining The Coding Institute in 2004, she’s also covered the ins and outs of coding for orthopedics, audiology, skilled nursing facilities (SNFs), and more.

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