With just one month left until the end of the Medicare Advantage Open Enrollment Period (MA OEP), now is the time to review your Medicare Advantage Plan. During the open enrollment period, you can sign up for a different MA plan, change your Part D prescription drug plan or switch to Original Medicare.
You should compare your current needs with the coverage provided by your existing plan. Anything from modifications in provider networks to a change in your health can affect the usefulness of your Medicare Advantage coverage. Consider these issues now, while you still have the opportunity to alter your Medicare selections.
1. Your doctors may not be covered if your plan’s network changed
This is a critical aspect of your healthcare. If you can't see the appropriate specialists, get to their facilities or if your preferred doctors are no longer part of your network, you should shop around. You may find a new plan that gives you access to the providers you have a relationship with or the providers you need.
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If you need any assistance reviewing plans or have any questions, you can get free, unbiased advice from a SHIPS (State Health Insurance Assistance Programs) representative in your state.
2. Your healthcare needs have evolved
As different health issues might arise, you may need a plan that better suits those needs. Another reason to reassess your MA coverage each year is that there may be a plan out there that’s a better fit. If you keep your MA selections on auto-pilot, you'll never know if there is a better plan for you or your budget.
Reminder:
Married couples don't have to enroll in the same MA plan, subscribe to the same Part D plan or buy the same Medigap coverage. Each person should evaluate how the plans will serve their unique healthcare needs. Despite the minor inconveniences that can arise from managing different plans, making sure you get the best coverage to address your needs will outweigh the additional work.
3. New plans may have better coverage
As new plans become available, it may be worth reviewing them to see if they offer you more of what you need or want. Comparing new options can help you find a more affordable plan, different supplemental benefits or expanded coverage compared to your current plan.
4. Different plans may have more competitive pricing
Your plan administrator is required to send you the "Plan Annual Notice of Change" (ANOC) each fall. Read it carefully so you understand what’s going on with your coverage. If your out-of-pocket maximums, premiums or copays have gone up — it might be time to shop around.
All Medicare beneficiaries pay the monthly Part B premium, but you may also have to pay the plan’s premium. Although many plans have a $0 premium, your plan's premium may have gone up.
Shop for a new Medicare Advantage or Part D coverage on the Medicare website. You can compare the different plans and their coverage. Before you decide on a plan, you can enter your prescriptions and select five local pharmacies to get a more accurate estimate of costs for plans in your area.
5. The star rating of your plan may have dropped
Every year, the Centers for Medicare and Medicaid Services (CMS) publishes the Medicare Advantage, also called Medicare Part C, and Medicare Part D Star Ratings. This rating system measures the quality of the health and prescription drug services received by those enrolled in the plan.
The Star Ratings system is meant to help people with Medicare compare the quality of Medicare health and drug plans being offered. A plan can get a rating from one to five stars. A 5-star rating is considered excellent. An overall plan rating can give you a single summary score that makes it easier for you to compare plans based on quality and performance. You can learn more about plans and see their ratings by using Medicare's Plan Finder Tool.
Bottom line
Every year it is worthwhile to re-examine a plan’s coverage, costs, drug coverage, and the pharmacies in its network to see if it best meets your current needs. After considering those factors, you can also use the plan’s star rating from Medicare to help you make a final decision. Don't set it and forget it. Your health is too important for you to neglect an opportunity to get the best care possible.
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