This article appeared originally in the December 2016 Levitt Letter.
Every year from Oct.15 to Dec. 7, Americans have the opportunity to change their Medicare coverage. Every year, many beneficiaries could save hundreds of dollars by changing plans. But every year, most of them do nothing. I believe people don’t bother with open enrollment because the information seems overwhelming. To help remedy that, I’d like to offer a few tips that can help you make good decisions:
Review your current plan. Plans can change, as can your needs. You should receive an Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC) if you have a Medicare Advantage Plan or a stand-alone Part D plan. Read them so you’re aware of any changes.
Make sure your doctor still accepts your particular Medicare Advantage Plan. If your healthcare provider’s affiliation changes, you may need to choose a new doctor or decide to pay more for your current doctor’s out-of-network costs.
Check your medications. Don’t just verify that your drugs are on your plan’s list; look carefully for restrictions like quantity limits or prior authorization. If your plan has a network-pharmacy benefit, check to see if the pharmacies covered are easy for you to access. Lastly, compare prescription-drug benefits across plans; you may be surprised at the amount of money you could save.
Consider premiums and out-of-pocket costs. Add up co-payments, co-insurance, and annual deductibles, along with the monthly premiums. Then compare costs.
Be aware of the Medicare Advantage maximum out-of-pocket limit. After you spend a certain amount “out of pocket,” you pay nothing for covered services. Different plans may have different caps, and the limits can change each year; so compare and review.
Get some help. Medicare.gov offers a Plan Finder tool where you can find and compare Medicare Advantage and prescription-drug plans available in your area. You can also contact your State Health Insurance Assistance Programs, or go through a licensed insurance agent who is experienced and knowledgeable regarding these plans. The services of an agent do not cost you anything. The insurance companies pay their commissions; your premium will be the same whether or not you use an agent.