Open Enrollment and Patient Advocates: What You Need to Know

Did you know there are four different types of Original Medicare, each with its own list of rules, regulations, and benefits? It’s a lot to take in. And when you throw in a dizzying number of Medigap policies and Medicare Advantage options, it can become totally overwhelming.

If you’re confused by your Medicare coverage or you're struggling to understand which plan is right for you, you’re not the only one. In fact, 65% of Americans find their Medicare plan confusing and hard to understand.

So, how can you know you’re choosing the plan that works best for you and your family? And what should you do if you need to change plans?

Let's start with the basics.

What is Medicare Open Enrollment?

Each year, Medicare recipients can make changes to their Medicare plans during a period called Open Enrollment. This year, that period runs from October 15 - December 7. This is your time to review your options and select the Medicare plan that’s right for you.

Each Medicare plan has its own list of benefits and exclusions, affecting everything from doctor’s visits and prescription drug coverage to hospital stays and outpatient care. You’ll need to decide which benefits matter most to you, and which ones you can live without. That’s a big choice for anyone.

On average, Medicare recipients have a staggering 43 plans to choose from during Open Enrollment. 

And this year your choice is even more important, because many large insurance providers have dropped their Medicare Advantage plans entirely, leaving nearly half a million Americans without health insurance. 

While choosing a Medicare plan, here are some helpful questions to consider:

• Are your preferred doctors and other providers in the plan network?
• Are your prescription drugs covered?
• Can you afford any out-of-pocket costs like premiums, deductibles, copays, and coinsurance?
• Does the plan provide additional coverage for vision, dental, or hearing care?
• Finally, is your patient advocate covered? And if you don’t currently have an advocate, will this plan cover one? 

Patient Advocacy and Original Medicare

Nearly 75% of Americans say the healthcare system is failing them, and it’s easy to see why. It’s just too big and confusing for anyone to navigate alone. Working with a patient advocate —an expert who knows the ins and outs of the system—can make all the difference. 

An experienced advocate can help you take charge of your healthcare. They’ll be your dedicated ally, working by your side to overcome your healthcare hurdles and get you the quality care you deserve.

And, as of 2024, patient advocates are now covered by Original Medicare, granting over 33 million Americans easy access to this essential service. 

If you choose an Original Medicare plan, you’ll be eligible for a Solace advocate. 

Solace is a nationwide network of expert advocates committed to getting patients like you the care they need. Solace advocates are experienced doctors, nurses, and other healthcare professionals who do the legwork to get you the results you deserve.

Patient Advocacy and Medicare Advantage Plans

Solace is currently covered by many Medicare Advantage plans, and more are added every day. Unfortunately, change takes time. Though Original Medicare began covering patient advocates in 2024, some Medicare Advantage plans still don’t cover Solace.

We’re working hard behind the scenes to bring Solace advocates to as many people as possible. In the meantime, if you’re thinking of switching to a Medicare Advantage plan, you could lose this benefit.

If you’re unsure whether your current plan covers patient advocacy or need help choosing one that does, give us a call at (240) 693-3281, and we’ll walk you through the best options in your area.

Advocates Improve Every Part of Healthcare

Having a healthcare advocate is like having a nurse in the family—someone who knows how to work inside the system and make it work for you.

They can schedule and manage your appointments, help fill out paperwork, and work personally with your doctors. They can help with medication management, resolve insurance disputes, and even negotiate your medical bills. 

The average doctor’s appointment in the United States lasts just over 15 minutes— barely enough time to stop for your morning coffee. Solace advocates value real relationships and spend, on average, over 6 hours a week working with their patients.

Over 92% of patients say working with an advocate had a positive impact on their healthcare.

Solace advocates are dedicated to removing every healthcare hurdle in your path, no matter how long it takes.

Learn more about what an advocate can do here. 

Why Do I Need an Advocate?

You wouldn’t go to court without a lawyer, so why visit a doctor without an advocate on your side?

It’s a sad reality, but navigating the healthcare system alone can be dangerous. Sometimes, even small paperwork errors can result in missed appointments, incorrect medications, or denied insurance claims. Your advocate is there to protect you and help you receive the healthcare experience you deserve.

Solace advocates are experts who know the pitfalls and traps of the healthcare system. They’ll cut through red tape, ensure your care is managed correctly, and keep your needs front and center so your health never falls through the cracks. 

To learn more about the ways an advocate can help, click here.

Other Considerations

Of course, getting a Solace advocate won’t be your only concern during Open Enrollment. Ultimately, nothing is more important than your health, and it’s crucial to choose the plan that works best for your healthcare situation as a whole.

Review your current plan carefully and list the benefits you’ve used the most. You should consider things like convenience, prescription drug coverage, and overall cost. Every plan comes with its own set of pros and cons. Familiarizing yourself with the benefits of your current plan is a great first step.

Though you’ll have many options during Open Enrollment, you’ll find that many of them don’t offer the benefits you need the most. The Medicare Plan Finder on www.Medicare.gov is a great tool to help narrow down your options and make choosing the right plan a little bit easier.

To ensure you’re choosing a plan that guarantees access to patient advocacy, please call us at (240) 693-3281

Enlisting the help of a dedicated patient advocate—an expert to fight for the quality care you deserve—is one of the most impactful decisions you can make for your health. 

Get started today.