Your Guide to 2023

Medicare Coverage
2022-2023

How to prepare
for AEP
Is it time for your
Medicare health plan
to have a checkup?

Confused about
Medicare?
We help you
understand your
plan options.

Does it pay to
compare
Medicare plans?
Find out how our
plan comparison
tools make it easy.

Don’t Forget:
The Annual Election Period runs
from October 15 - December 7
every year.
 Your Guide to 2023 Medicare Coverage 02

2023 Medicare Update: 


What's New with Medicare?
COVID-19 test and treatments Medicare Advantage

During the COVID-19 public health Plans continue to offer extra benefits

emergency, Medicare may cover:

In 2022, a vast majority of Medicare
• COVID-19 vaccines and boosters

Advantage plans include benefits beyond

Original Medicare (Part A and Part B).
• COVID-19 at-home test kits at no cost Kaiser Family Foundation (KFF) reports
to you. Just go to a pharmacy, doctor, that more than 90% of Medicare
hospital, or laboratory. In some cases Advantage plans include some routine
your specimen may be collected in dental, vision, and/or hearing coverage–
your home for this test.

as well as fitness benefits. Most 


plans offer telehealth services and 

• A COVID-19 laboratory test. An
meal benefits.

authorized healthcare professional

More plans available-with lower

can order this, or you can get one test

average premium

without an order.

• FDA-authorized monoclonal antibody

treatments. If you test positive for

There are more Medicare Advantage
COVID-19, these treatments might plans available nationwide than ever
keep you out of the hospital. You have before, according to the Kaiser Family
to meet certain conditions to be Foundation. The average Medicare
eligible for these treatments.

beneficiary has 39 Medicare Advantage

plans to choose from.

• Antibody tests, authorized by the FDA.

These tests may show whether you’re

The average monthly premium dropped
not at immediate risk of a COVID
more than $2 from last year, to $19 in
infection because your body has
2022, according to the Centers for
Medicare & Medicaid Services.

developed an immune response.

Speak with a licensed insurance agent:

http://www.ehealthmedicare.com/guide
1-844-920-1269 (TTY 711)
 Your Guide to 2023 Medicare Coverage 03

Recent Medicare changes

Cognitive impairment test Colorectal cancer screening

If you’re worried about cognitive Colorectal cancer is the third most

impairment, whether in yourself or common type of non-skin cancer and
a loved one, you might want to know the second leading cause of cancer
that Medicare now covers an early deaths in the United States, according
diagnosis test. Medicare generally also to the National Institutes of Health.

covers a separate visit with your doctor

to further evaluate your condition and Medicare now covers another type of
develop a care plan if necessary.

colorectal cancer screening (in addition

to other screenings for this disease).
Cognitive impairment is a condition Once every three years, Medicare may
where you have certain memory cover a blood-based biomarker test if
problems, trouble learning new things, all of these are true for you:

concentrating, or making what were

once easy decisions, according to the • You’re between age 50 and 85.

Centers for Disease Control.

• You’re at average risk for

colorectal cancer.

• You don’t have symptoms of

this disease.

Routine Dental Coverage Included with Most Medicare Advantage Plans

According to the Kaiser Family Foundation (KFF):
• Nearly half of Medicare beneficiaries (47%) had no
routine dental coverage in 2019.
• But Medicare Advantage plans often cover routine dental
care. In fact, about 94% of Medicare Advantage plans
have routine dental coverage (as of 2022).

Savings on insulin
Medicare expanded the Medicare Part D Senior Savings
Model in 2022. If your Medicare prescription drug plan
participates in the program, you could pay no more than
$35 a month for insulin. Ask your plan if it’s part of the
program, and if the insulin you take qualifies.

http: // www.ehealthmedicare.com / guide Speak with a licensed insurance agent:

1-844-92 0 -1269 (TTY 711)
 Your Guide to 2023 Medicare Coverage 04

How to Prepare for AEP:

Does your Medicare Health
Plan Need a Checkup?
The Annual Election Period (AEP) is an opportunity to boost your Medicare
benefits. Whether you want to change from traditional Medicare (Part A and Part
B) to a Medicare Advantage plan, change from your current plan to one that may
cost you less, or make other changes, AEP is a great time to do this. Take a look at
your current Original Medicare coverage, Medicare Advantage plan, or Medicare
Part D prescription drug plan. Is it still meeting your needs? If not, your AEP 

(a Medicare enrollment period) is a perfect time to compare plans and make
coverage changes.

Here's a simple, straightforward guide to what the AEP is all about. In this
guide we'll cover:

• What is the Annual Election Period (AEP)?

• Medicare Basics

• Medicare Advantage–Part C Overview

• Medicare Part D Overview

• Medicare Supplement Insurance

• Medicare FAQs

• How eHealth Makes AEP Easy

Tips on preparing for the AEP, continued on page 12.

Speak with a licensed insurance agent:

http://www.ehealthmedicare.com/guide
1-844-920-1269 (TTY 711)
 Your Guide to 2023 Medicare Coverage 05

What is the Annual Election

Period (AEP)?
The Annual Election Period (or AEP) is a Medicare enrollment
period that runs from October 15 December 7 every year. You
can make various coverage changes during this time.
Why is AEP important? What coverage changes can
you make during AEP?
This can be a perfect time to make
changes to your Medicare coverage. Here's what you can do during this
An eHealth survey from fall 2020 Annual Election Period:
showed that many people may be able
to save by changing prescription drug • Sign up for a Medicare Advantage plan

plans, whether you have:

• Switch from one Medicare Advantage

• A Medicare Advantage prescription plan to another

drug plan, or

• Sign up for a stand-alone Medicare Part

D prescription drug plan

• A stand-alone Medicare Part D

prescription drug plan

• Switch from one Medicare Part D

If you don't already have prescription drug plan to another

prescription drug coverage, adding

it during AEP might save you money • Drop your Medicare Advantage plan
and return to Original Medicare

on your prescriptions.

• Drop your stand-alone Medicare Part D

prescription drug plan

You can get "all-in-one" coverage through a Medicare Advantage prescription

drug plan. Learn more about these plans.

Do you have to switch plans

during the AEP?
You don't have to make any changes during AEP. 

It's entirely up to you. But, it's an excellent chance to
review your Medicare coverage. You might find 

a Medicare plan option that better fits your budget 

and health needs.

http: // www.ehealthmedicare.com / guide

S peak with a licensed insurance agent:
1-844-920-1269 (TTY 711)
 Your Guide to 2023 Medicare Coverage 06

Medicare Basics
Traditional Medicare, also called Original Medicare, gives you hospital
coverage through Medicare Part A and medical coverage through Medicare
Part B. You typically get a wide range of coverage for medical services. There are
deductibles, coinsurance, and/or copayments for many services.

But did you know you have options when it comes to your Medicare coverage?
You don't have to stay with just Original Medicare, Part A and Part B. Here's what
Original Medicare doesn't have:

Prescription drug coverage for most medications you take

at home

A cap on how much you can spend on covered medical costs

in a year

Routine dental, vision, or hearing care

There are ways you can expand your

Medicare coverage. For example, you can
decide to get your Medicare Part A and Part
B coverage through a Medicare Advantage
plan. These are available from private,
Medicare-approved insurance companies.

Medicare Advantage plans provide your

Part A and Part B benefits. Most include
prescription drug coverage and offer extra
benefits, like routine dental care. However,
plans vary and can change year to year, so
it's a good idea to compare plans in your
area to determine which offer benefits
that fit your coverage needs. Read on to
learn more.

S peak with a licensed insurance agent:

http://www.ehealthmedicare.com/guide
1-844-920-1269 ( TT Y 711)
 Your Guide to 2023 Medicare Coverage 07

Medicare Advantage
(Part C)
Medicare Advantage, also called Medicare Part C,
gives you another way to get your Medicare Part
A and Part B benefits instead of getting them
directly through the government.


Medicare Here's how Medicare Advantage works:
Advantage plans
can have • A private health insurance company contracts
premiums as low with Medicare to deliver Medicare Part A and
Part B benefits to you upon enrollment.

as $0 per month
• Most Medicare Advantage plans include
Important to note: prescription drug coverage that Medicare Part
A and Part B don t cover.

• You may still pay an

annual deductible,
copayments, and/or
• Many Medicare Advantage plans offer extra
benefits beyond Medicare Part A and Part B. 

coinsurance. You're A few examples are: routine dental, vision,
still on Medicare when and hearing care, fitness program
you have a Medicare memberships, and emergency alert systems
Advantage plan. (to send help if you fall).

• You're still on • Each Medicare Advantage plan has an annual

maximum out of-pocket spending limit. This
Medicare when you
have a Medicare limit protects you from skyrocketing medical
Advantage plan. You costs in case you have a serious illness.

still have to pay your • Many Medicare Advantage plans require you
monthly Medicare to see doctors in their plan networks.

Part B premium
along with any • You need to have Medicare Part A and Part B
premium your plan to qualify for a Medicare Advantage plan. You
may charge. must live within the plan's service area.

http://www.ehealthmedicare.com/guide Speak with a licensed insurance agent:

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 Your Guide to 2023 Medicare Coverage 08

Medicare Part D
Medicare Part D is prescription drug coverage. This doesn't come with Original
Medicare, Part A or Part B, except in limited situations. If you want coverage for
medications you take at home, you need to enroll in a Medicare Part D prescription
drug plan.

How can you get a Medicare plan with prescription

drug coverage?
• Through an all-in-one Medicare Advantage
prescription drug plan, or

• Through a stand-alone Medicare Part D

prescription drug plan

Both types of plans are available from private,

Medicare-approved insurance companies. To see
which options are available in your area, visit
eHealth's plan comparison tool.

You need to have Medicare Part A or Part B to qualify for a stand-alone Medicare
Part D prescription drug plan. You must live within the plan's service area.
What else should you know about Medicare Part D
prescription drug plans?
Plans can have annual deductibles. This is an amount
you must pay before your plan helps pay for your
medications. However, there's a cap on your
deductible. Medicare sets a maximum deductible
amount every year.

A stand-alone Medicare Part D prescription drug plan

might be a good idea if you decide to stay with Original
Medicare, even if you buy a Medicare Supplement
insurance plan. (Medicare Supplement insurance plans
sold today don't cover prescriptions.)

To protect you against unlimited spending on prescription drugs, there are some
protections in place. Medicare has coverage phases that you might pass through
if you spend a lot on prescriptions. One of these phases is sometimes called the
donut hole, or coverage gap.

http :// www.ehealthmedicare.com / guide Speak with a licensed insurance agent :

1-844-920-1269 (TTY 711)
 Your G uide to 2 20 3 Medicare C overage 09

Medicare Part D Coverage Gap

M edicare art D
coverage can be
P

(“Donut Hole”) confusing even 


for people who ve ’

The coverage gap (sometimes called the “donut hole”) refers to the had edicare for 

M

point when you and your Medicare Part D Prescription Drug Plan 
 a long tim e

(or Medicare Advantage Prescription Drug Plan) have spent a set

amount on covered medicines; this amount is also known as your B e sure to ask your
initial coverage limit.

insurance company
or broker how this
This means there is a temporary limit on what the prescription benefit works. y B

drug plan will cover for medications. Once you reach your initial knowing how Part D
coverage limit, you might pay a different portion of your prescription works, you will 

drug costs but no more than 25%.

get the most from

your coverage.
After you spend the set amount out-of-pocket, you’re out of the
coverage gap and you automatically receive catastrophic coverage.
This means your Medicare Part D Prescription Drug Plan will pay for Does it pay to
most of the cost of your covered prescription medicines. You only compare plans ?

pay a small copayment or coinsurance until the end of the year.

It certainly does An !

e ealth survey of
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Medicare beneficiaries
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Annual
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Not everyone will enter the coverage gap. You can prevent or delay More than % of 90

entering it by reducing your prescription drug costs. There are many them could have saved
ways to do this, including: money by switching to
the plan that best fit
their needs .

Switch to lower cost medications (including generics) 


after first talking to your doctor.

Enroll in and use a reputable prescription drug

assistance program.

Use a prescription mail-order program if offered by your

Medicare Part D Prescription Drug Plan.

Apply for Extra Help with a Low Income Subsidy (or LIS)
program. If you qualify, you will not be subject to the 

Part D coverage gap.

http: www.ehealthmedicare.com guide

// /
Speak with a licensed insurance agent:
1 - -
844 - TT
920 1269 ( Y 711)
 Your Guide to 2023 Medicare Coverage 10

Medicare Supplement Insurance

Medicare Supplement (or "Medigap") insurance plans help fill "gaps" in Original
Medicare and are sold by private companies. Original Medicare pays for much, but not all,
of the cost for Medicare-covered healthcare services and supplies.

Medicare Supplement insurance plans:

• Might help pay your Medicare Part A and Part B out-of-
pocket expenses like deductibles, coinsurance, and
copayments.

• Are standardized across most of the country. Select

plans have some benefits in common, but it’s important
to compare plan options to ensure they meet your
coverage needs.

Most Medicare Supplement insurance plans:

• Do not restrict you to a provider network. You can usually
use any doctor who takes Medicare assignment.

• Charge a monthly premium and are guaranteed

renewable as long as you pay your premium. Once you
have a plan, the insurance carrier can't drop you if you
develop a health issue.

• Cover you in any state, whereas Medicare Advantage

plans might not cover you (or might charge you more) if
you get care outside the plan's service area.

• Generally cover your hospital care for up to a year after

your Medicare Part A benefits run out.

Some Medicare Supplement insurance plans:

• Have out-of-pocket limits. Translation: if you spend 

a certain amount on Medicare-covered costs within one
year, the plan may cover all of your Medicare costs for
the remainder of the year.

Speak with a licensed insurance agent:

http://www.ehealthmedicare.com/guide
1-844-920-1269 (TTY 711)
 Your Guide to 2023 Medicare Coverage 11

How does Medicare What if you decide you want

Supplement insurance a Medicare Supplement
relate to AEP? insurance plan?
Medicare Supplement insurance plans • If you don't have a Medicare Advantage
are different from Medicare Advantage plan, you can apply for Medicare
plans and Medicare Part D prescription Supplement anytime, as long as you're
drug plans. You can apply for a Medicare enrolled in Medicare Part A and Part B.

Supplement plan at any time as long as

you have Part A and Part B. You can only • If you have a Medicare Advantage plan,
enroll in a Medicare Advantage plan or you'll want to cancel it before buying
Medicare Part D prescription drug plan Medicare Supplement insurance. These
during certain enrollment periods, like types of plans don't work together

AEP (October 15–December 7).

Medicare Supplement Open Enrollment Period

Your Medicare Supplement Open Enrollment Period is the six-month period that starts
automatically the first month you have Medicare Part B (and you're 65 or older)

Guaranteed Issue Rights (also called H ere are some examples of when you
Medigap Protections ) are rights you have 
 typically have guaranteed-issue rights:
in select situations when insurance
companies must offer you certain Medicare • You're still in your Medicare
Supplement policies. In these situations, 
 Supplement Open Enrollment Period.

an insurance company:
• You joined a Medicare Advantage
• Must sell you a Medigap policy

 plan when you were first eligible for
Medicare Part A at 65, and within the
• Must cover all your pre-existing first year of joining, decided to switch
health conditions

 to Original Medicare (known as a Trial
Right ).

• Can't charge you more for a Medigap

policy because of past or present • You're in a Medicare Advantage plan,
health problems and you move out of the plan's
service area.

• You have Original Medicare and an

employer group health plan or union
coverage that pays for Medicare, and
that coverage is ending.

Speak with a licensed insurance agent:

http: / / www.ehealthmedicare.com / guide
1-844-920-1269 (TTY 711)
 Your Guide to 2023 Medicare Coverage 12

Medicare FAQs

How do I prepare for AEP?

• Review your plan Annual Notice of Change (or ANOC). It tells you about
any benefits that have been added or dropped, prescription drugs added
or dropped, and other changes.

• Prepare a list of your medications, including dosage.

• Compare plans to see if you could save money with a different plan.
eHealth's PlanPrescriber® and Customer Center tools make it quick
and easy – more on that below.

Why do I need my zip code to shop for Medicare plans?

While Original Medicare (Part A and Part B) benefits are the same across the country,
additional Medicare Advantage benefits can vary. Medicare Advantage providers and
low-cost monthly premium options may also change depending on location.

What is a licensed insurance agent?

At eHealth, we have more than 500 licensed insurance agents who are accredited
across the United States. When you call, you are paired with an agent certified in your
state that can answer any questions specific to your Medicare options.

Speak with a licensed insurance agent:

http://www.ehealthmedicare.com/guide
1-844-920-1269 (TTY 711)
 Your Guide to 2023 Medicare Coverage 13

How eHealth makes the AEP easy

eHealth's PlanPresciber® offers a simple, trustworthy way to shop for
Medicare health and prescription drug plans online—anytime you want, with
no obligation to enroll.

Simply enter your desired monthly premium and PlanPrescriber® will search for
affordable plans to fit your budget.

eHealth offers the newly-enhanced eHealth Customer Center—a simple,

secure tool that saves you time and lets you:

• Manage your Medicare plan online

• See what's changing with your plan 


in the coming year

• Shop for and compare plans

• Search for plans that maintain 


your current prescription drugs 

and doctors

• Resume an application right where 


you left off

• Track your application status

Powered by eHealth’s PlanPrescriber® proprietary technology, the eHealth

Customer Center sifts through thousands of plans to recommend a personalized
list of coverage options that may be right for you. Customer Center’s flexibility
lets you seamlessly transition between completing an application online or with
an agent.

Speak with a licensed insurance agent:

http://www.ehealthmedicare.com/guide
1-844-920-1269 (TTY 711)
http://www.ehealthmedicare.com/guide
Speak with a licensed insurance agent:
1-844-920-1269 (TTY 711)