Medicare recipients are facing more choices than ever before this Annual Enrollment Period (AEP) as carriers roll out plans with rich benefits, zero dollar premiums, and even reimbursements on Part B premiums.  So how should you narrow down the many options?  Here are some things to look for when contemplating a plan change.

  1. Look beyond the gimmicks.  A plan might have a lot of benefits, but if your doctor isn’t in the network, or if the network is so skinny you will have trouble finding providers, it might not be worth all the “extras”.
  2. Look at your ANOC, Annual Notice of Changes, to see if your plan is still the best one for you. If your premium or deductible is going up or your out-of-pocket maximum, you might consider a change.  Also, look at benefit changes.  Did your copays and coinsurance increase?  Are your medications still covered in the plan’s formulary? 
  3. Plans change networks frequently, so make sure your doctor is still in the plan’s network.  Also, look at any specialists you’ve been seeing to make sure they’re still in network as well.  Remember, if you go out of network, with most Advantage Plans, you will not be covered.
  4. Some plans have special features like low-cost insulin for people with diabetes.  These plans cap insulin costs at $35 or lower.  There are also plans now for those with End Stage Renal Disease that will help cover the cost of dialysis and plans for those with chronic medical conditions like heart disease.  If you have any of these conditions, these plans would be worth a look.
  5. There are also rich plans for those on Medicare and Medicaid.  These plans help coordinate care, give you extra benefits, like transportation to and from doctors’ appointments and meals after a hospital stay, and make it easier to find providers that accept both Medicare and Medicaid.
  6. Not all plans are available in all areas.  Plans are divided into service areas (usually a county) so they are specific to that region.  Make sure you are looking at plans in your area when comparing benefits, pricing, and provider networks.

Leave a Reply

Your email address will not be published. Required fields are marked *