If you are age 65 or older, you likely already know what’s in store over the next two months: Endless phone calls and ads with promises of additional benefits and lower premium health care plans.
So, with salesmen battering down your door, how do you make the decision whether to change or not to change?
First, let’s start with the Annual Enrollment Guidelines: you have from October 15th to December 7th to make adjustments to your Part D prescription plans and Advantage plans with a January 1st effective date. Although Medicare Supplements may be rewritten at any time during the year, we typically recommend making policy changes during this time period consistently to avoid paying an annual deductible twice in one year.
If you currently have a Medicare Advantage plan you will be able switch over to a new plan without any medical underwriting. Each plan will have varying deductibles, co-insurance, premiums, and added befits such as basic dental or vision care. They also typically have different provider networks. It is important to consult with your team of physicians before making any changes to ensure you won’t be charged out of network costs with your new policy.
If you’re healthy, you have a good shot of being medically underwritten for a Medicare Supplement plan - though there is an application process of 1-2 weeks during which you are either accepted or rejected. Medicare Supplement plans come with coverage guidelines developed by the Center for Medicare and Medicaid Services and will not differ from company to company. They will, however, differ in premium pricing and future premium increases. The most comprehensive Medicare Supplement plan available to new Medicare recipients is Plan G. Medicare Supplements, specifically Plan G, differentiate themselves from Advantage plans by having no networks or co-insurance once the Part B deductible is met ($203 in 2021).
Lastly, it is also beneficial to review your Part D prescription coverage each year (if it is not included in your Advantage Plan) due to medication and pharmacy changes. When choosing a prescription plan you will want to make sure to pick a plan that has your pharmacy of choice as a preferred in-network pharmacy. This will help reduce your out of pocket expenses. You will also have the ability to choose a deductible and corresponding monthly premium that work best for your individual needs.
Over the years we’ve seen individuals with varying plans that do not always fit their specific needs. Common Medicare pitfalls might include:
- Being a jet setter with big travel goals, but enrolled in an Advantage plan with a limited local network.
- Moving to a new county and failing to update your Advantage Plan or prescription coverage within the 60-day allotted time frame. (This will likely limit you to out of network providers)
- Not rewriting your Medicare Supplements every 1-2 years to keep your premium costs down.
Individual Medicare Advantage Plans, Supplements, and Part D prescription plans can all be further researched on the Medicare.gov website, but Medicare and its benefits can be complicated. That’s why this year’s Medicare handbook is over 120 pages long. For the best experience with your healthcare, we recommend consulting a trusted advisor or your local Area Agency on Ageing to find the best product for you.