Confused by all the Medicare ads? Here are 5 tips for picking a Medicare plan
The pandemic has made it clearer than ever — maintaining good health is critical, and it all starts with having a health plan that works for you every day, and especially in times of greater need.
If you qualify for Medicare, the Medicare Annual Election Period (AEP), which runs from Oct. 15 through Dec. 7, is an opportunity to ensure you have needed coverage.
“Now is the time to understand and evaluate your benefits and anticipate the care you may need in 2022,” says Gary Culp, chief growth officer for Medicare at Cigna.
If you’re signing up for Medicare or a Medicare Advantage plan for the first time or making changes, you can do so during AEP. In both cases, the new benefits will kick in on Jan. 1, 2022. However, if you like your current plan and want to stick with it, you can do so.
To evaluate your current plan, Culp recommends writing down what you like about it, including which aspects are essential to you. Based on your needs, review other plans to see how they stack up.
The process of choosing a health plan can be overwhelming. However, you can eliminate some of the confusion by seeking advice from your doctor or family and friends. By attending in-person or virtual seminars or calling independent health plan agents, you can have your questions addressed by experts. You can also visit your state health insurance assistance program for additional information.
In the meantime, keep these tips in mind as you review plans:
▪ Estimate total costs: Make sure you know the current premium or monthly cost of your plan. Second, check your Annual Notice of Change (ANOC). This is a letter mailed in late September that details changes to out-of-pocket costs, including co-pays and deductibles on doctor and hospital visits and prescription drugs. Finally, check to see the costs associated with visiting a specialist.
▪ Ensure providers are in-network: One common reason to change your coverage is if your favorite doctors are no longer in-network in a Medicare Advantage HMO. (If you pick Original Medicare, you won’t have this issue as the vast majority of doctors accept Medicare.) If you choose a Medicare Advantage plan from a private insurance company, confirm that your current providers and any specialists you expect to visit in 2022 are still in your plan and that any new doctors you’ll be visiting accept new patients. If not, you might have to change plans or switch doctors to avoid paying more out of pocket.
▪ Review your prescriptions: Review the drug pricing tiers to determine whether your prescription plan will cover your current medications and the costs. Keep in mind, some drug plans require prior authorization for certain brand-name drugs.
▪ Consider extras: Take a close look at extra benefits, such as dental, vision, healthcare-related transportation and virtual care visits, that go beyond what’s provided by original Medicare and may be built into a private insurer’s Medicare Advantage plan. Some plans may even include additional health and wellness benefits that help you stay healthier, like fitness programs.
▪ Be aware of travel restrictions: If you plan to travel or have another home out of state, consider plans with that in mind. You may have to purchase a Medigap plan so you are covered if out of state or out of the country.
“Making sure your health plan meets your needs is up to you. After finding the right plan, be sure to take advantage of your benefits for a healthy, happy 2022,” says Culp.
For more information, go to Medicare.gov
This story was originally published October 12, 2021 at 6:00 AM.