Medicare open enrollment ends Dec. 7

Find information and resources to help make the best choice for you.

NO CAPTION. Logo to accompany news of Washington state.

EDMONDS — Finished shopping Black Friday and Cyber Monday sales? It’s time to buy or change your Medicare coverage by Dec. 7.

The Centers for Medicare & Medicaid Services recommends that you compare plans every year to keep up with changes in those plans and your own health needs.

You have a lot to choose from when looking at Part D and Medicare Advantage plans. According to the Kaiser Family Foundation, Snohomish County residents have 55 Advantage plans to choose from for 2023 — the most in the state, and more than the national average of 43.

Medicare Part A, or hospital insurance, is free for most people age 65 and older. But you pay for Part B medical/outpatient insurance, and also Part D drug/prescription insurance.

Original Medicare operates like a preferred provider network, where you can go to any provider that accepts Medicare, without referrals. In 2023, Part B will cost a minimum of $164.90 per month. But the drug plan is not included: you can buy a Part D plan for less than $2 per month.

Also, original Medicare has no cap on what you might spend out-of-pocket. Some folks buy a Medigap/Supplement, or use employer or Medicaid coverage.

Medicare Advantage plans frequently operate like an HMO. They are legally required to cap out-of-pocket expenses, and they almost always include prescription coverage. They also might cover extras that original Medicare does not, like vision, hearing and dental services.

Medicare Advantage plans are popular — 60% of the eligible population in Snohomish County is enrolled in one. But that doesn’t mean it is the best choice for your unique situation. For example, if you travel a lot and get sick, you might spend up to the out-of-network cap on your plan. That could be as much as $12,450 in 2023.

To help decide, you can use a Medicare online tool, work with an insurance broker, or find free clinics and advisors through the Statewide Health Insurance Benefits Advisors (SHIBA) program.

Based out of the Edmonds Waterfront Center, SHIBA advisors meet by phone, Zoom, and in-person at locations across Snohomish and Skagit counties. They provide education and guidance as Medicare-eligible people weigh their options.

“We’re required by oath to be unbiased,” said Suzi Haugen, a volunteer advisor for the past 10 years. “We don’t sell products, and we’re not involved in insurance. Really, what we do is educate.”

First-time SHIBA clients attend a short “Welcome to Medicare” workshop, offered most weeks by Zoom. After that, they can make a one-on-one appointment with an advisor.

It’s the busiest time of year right now, but as of last Wednesday, they still had a few openings before Dec. 7, said volunteer coordinator Sue Shearer.

The 32 advisors receive extensive training from both the Washington Office of the Insurance Commissioner and the Edmonds Waterfront Center’s own programming.

Haugen, a former human resources professional, was looking for something to do in retirement that would make her brain work hard. Through SHIBA, she helps people trying to meet their health needs, often with limited financial resources. So it’s not only “brain-exhausting,” but also “emotionally intense,” she said.

Importantly, a number of resources are available for people who face financial challenges in paying premiums or other medical bills. SHIBA advisors screen everyone for eligibility for those programs.

Other than that, ask your favorite doctors if they will accept original Medicare (most do) and which Advantage plans they will contract with in 2023.

As The Daily Herald reported last week, Regence plans and Optum — the parent of The Everett Clinic and The Polyclinic — have not agreed to a new contract for next year. As of now, Optum companies will be out-of-network effective Dec. 5, but Regence will cover claims from Medicare Advantage subscribers until the federal COVID public health emergency ends. Currently, that is Jan. 11, 2023. Federal law requires such coverage during emergencies or disasters.

The Daily Herald has since heard from Aetna Medicare Advantage members that Optum will not be in network for them effective Jan. 1, 2023. Aetna wrote in a statement that Optum ended the agreement only with the Medicare Advantage PPO and HMO networks, not the commercial network.

Aetna’s spokesperson wrote:

“During the last several months, Aetna has made significant efforts to avoid a termination and to reach a mutually satisfactory resolution for all parties. Aetna will continue to provide our Medicare Advantage members in the Washington market with access to a robust network that provides affordable care that is local, convenient and helps achieve better health.”

Optum has not yet responded to a request for comment.

Even if you can’t get an appointment with SHIBA before Dec. 7, Haugen recommends coming in any time during the year to get educated for the next open enrollment period. And for those enrolled in Medicare Advantage, you can change your plan once from Jan. 1 to Mar. 31.


SHIBA: or 425-290-1276. The next Welcome to Medicare information session is Nov. 30 at 6 pm. Register online.

Medicare overview:

Explore your options with this tool: or 1-800-MEDICARE

Research about Medicare:

Joy Borkholder is the health and wellness reporter for The Daily Herald. Her work is supported by the Health Reporting Initiative, which is sponsored in part by Premera Blue Cross. The Daily Herald maintains editorial control over content produced through this initiative.

Joy Borkholder: 425-339-3430;; Twitter: @jlbinvestigates.

Talk to us

More in Local News

Logo for news use featuring the municipality of Mountlake Terrace in Snohomish County, Washington. 220118
Mountlake Terrace council taps planning commissioner for open seat

With five votes, Rory Paine-Donovan was affirmed to join the ranks of the Mountlake Terrace City Council.

CEO Amy King standing outside of a Pallet shelter. (Courtesy of Pallet)
After rapid rise, Everett’s Pallet hits milestone: 100 shelter villages

Temporary home manufacturer Pallet hires locals who have “experienced homelessness, substance abuse or the justice system.”

Locals from the group Safe Lynnwood gather in front of the Ryann Building on 196th Street SW to protest the opening of a methadone clinic in the building on Sunday, Jan. 22, 2023, in Lynnwood, Washington. (Ryan Berry / The Herald)
Despite controversy, Lynnwood opioid treatment center opens its doors

For weeks, protesters have objected to the center opening near Little League fields and a Boys and Girls Club.

A man was injured and a woman found dead Sunday night after an RV fire in Marysville. (Marysville Fire District)
Woman dead, man burned in Marysville RV fire

The Snohomish County Fire Marshal’s Office and Marysville Police Department were investigating the cause of the fire.

Ismael Cruz-Sanchez speaks at his sentencing at the Snohomish County Courthouse on Monday, Jan. 30, 2023 in Everett, Washington. (Olivia Vanni / The Herald)
Driver in fatal I-5 crash in Arlington gets 10 years

Ismael Cruz-Sanchez had a lengthy history with impaired driving. He pleaded guilty to killing Jason Vogan, 45.

Logo for news use featuring the municipality of Snohomish in Snohomish County, Washington. 220118
Boil water advisory in effect for 75 Snohomish homes

A water main break resulted in outages and possible contamination Sunday. Service was expected to return by Wednesday.

NO CAPTION NECESSARY: Logo for the Cornfield Report by Jerry Cornfield. 20200112
No right turns on red gets a look, a bid to expand sports betting arrives

It’s a new week. Here’s what’s happening on Day 22 of the 2023 session of the Washington Legislature

The final 747 is revealed during a celebration in Everett, Washington on Tuesday, Jan. 31, 2023. The plane was rolled out Dec. 6 from the Everett assembly factory and delivered to the customer, Atlas Air. (Annie Barker / The Herald)
‘Still jaw-dropping’: Last Boeing 747 takes the stage in Everett

Thousands, including actor John Travolta, gathered at Boeing’s Everett factory to bid goodbye to the “Queen of the Skies.”

Logo for news use, for stories regarding Washington state government — Olympia, the Legislature and state agencies. No caption necessary. 20220331
Lobbyist barred from WA Capitol after ruling he stalked representative

State Rep. Lauren Davis, D-Shoreline, obtained a domestic violence protective order against longtime lobbyist Cody Arledge.

Most Read