7 Things to Consider When Choosing Medicare Coverage During AEP
There are a few things to consider when choosing Medicare coverage during AEP, we’ll discuss the top 7 things to consider when selecting a plan. Medicare’s Annual Enrollment Period is around the corner; you can save money by reviewing your current coverage and comparing it with other options.
The Annual Enrollment Period is your opportunity to make changes to your Medicare Advantage plan or Medicare prescription drug coverage, including changing plans or switching from traditional Medicare to a Medicare Advantage plan.
Many people don’t realize that Medicare Advantage and prescription plans can change from one year to the next. That means a plan that was perfect for you this year may be much more expensive next year.
Another plan may have lower premiums, a better provider network, or lower copays for doctor visits and the prescriptions you take.
You can also switch from Medicare Advantage to traditional Medicare during the AEP. Also, beneficiaries can enroll in coverage for the first time.
Here are 7 things to consider when choosing Medicare coverage during AEP.
1. Cost of Monthly Premiums in 2020
You should receive a document in September from your Medicare Advantage and prescription plans called a Plan Annual Notice of Change.
The notice of change explains how your Medicare plan will be different in 2020—including whether you’ll pay a different monthly premium next year.
Look at the 2020 premium for your current plan and compare it with the amount you’re now paying. A significant increase is a good sign it may be time to shop around for a new plan.
2. Medication Coverage
A new year can also bring changes to your prescription drug plan’s formulary (the list of covered drugs), the pricing tiers that drugs are placed in, or the copays required for various types of drugs.
In addition, some Medicare Advantage prescription plans now require prior authorization for certain expensive brand-name drugs, potentially making it more difficult to get Medicare to cover these medications.
Find out whether your prescription plan will cover your current medications in 2020, and how much you’ll pay for them.
If you take expensive medications, it’s a good idea to explore other prescription plans to see if they have lower copays.
3. Expected Annual Medical Costs
Make a list of the doctor visits and procedures you expect for 2020. Then estimate what you will pay for them out of pocket with your current Medicare plan.
Add in a years’ worth of premiums and you’ll have a good estimate of what your healthcare will cost you next year.
You can do this same calculation with other Medicare plans you’re considering, to compare the overall cost of one plan to another.
4. Healthcare Providers in the Plan’s Network
A new year can also bring changes to your Medicare Advantage plan’s network of doctors. Confirm that your current providers will still be in your plan’s network for 2020.
If they aren’t, you will have to change plans or providers or pay much higher out-of-pocket costs to stay with the same doctors and the same plan.
Another option is to switch to traditional Medicare coverage with a Medigap plan. Although you will have to answer questions about your health to enroll in Medigap, there are no provider networks with Medicare and Medigap.
You can see any healthcare provider that accepts Medicare.
5. Doctors and Pharmacies in the Plan
If it’s hard to get to the doctor or the drug store, you may not take the best care of your health. Or, if you travel frequently, you may delay getting care until you are at your primary home.
Make sure your plan has providers and pharmacies near where you live.
If you live in two places or plan to spend a lot of time out of state, consider a plan with a nationwide network, or traditional Medicare, which does not have provider networks.
6. Vision, Dental and Hearing Coverage
Traditional Medicare doesn’t cover routine dental, vision and hearing services, but some Medicare Advantage plans do. You can also buy dental, vision and hearing coverage separately.
Consider your needs and the available coverage as part of your overall evaluation of Medicare plans.
7. Plan Ratings
The Centers for Medicare and Medicaid Services has a star rating system to help consumers compare Medicare plans.
Medicare Advantage and prescription drug plans receive an overall star rating of one to five stars—with five being the best—on factors such as customer service, member experience, and member complaints.
Medicare Advantage plans are also rated on preventative care to help people stay healthy, and management of chronic conditions.
If your current plan gets low marks, you may be happier with another option. After you consider these 7 things you’re ready to choose Medicare coverage during AEP.
Shopping for Medicare coverage can be complicated, but if you take the time to evaluate your current coverage and compare it with other types of plans, you’re likely to be more adamant about maintaining your health. You can compare rates by calling the number above or filling out an online rate comparison form.