5 TIPS to help you find a better Medicare Advantage plan for yourself, friend or family member. These tips are a good way the make sure you stay in a plan which works best for you and the type of care you need.
Keep in mind, Medicare Advantage plans are available in your county of residence. Some counties have plenty to choose from, other counties don’t have any Advantage plans.
A few tips to keep in mind …
- HMO’s … When looking for a Medicare Advantage plan, you will notice most are HMO style plans. The Premiums are typically very low, sometimes $0. To compare the plans in your county, you can visit the Medicare website, enter your zip code and compare what is available in your area.
- Open-Enrollment … Each year, Medicare Advantage plans have an “Annual Open Enrollment” period which starts October 15 and ends December 7. Any changes made during this time have an effective date of January 1. This is an excellent time to compare new plans available for the next year and also to view what changes your current plan will have.
- Part D is included … With your Medicare Advantage plan, the Part D Rx coverage is typically included with the plan. If you are on any specialty drugs or on several prescriptions, you will want to compare plans not only for the medical coverage but also how well the plan covers your prescriptions. This is very important because of how expensive some medications cost. Each Medicare Advantage plan can treat medications differently with how well it is covered. Your total out of pocket costs are not only for medical coverage but also with prescription costs. Choosing the wrong plan can be costly.
- Dis-enroll … If you do not want to keep your plan, and choose to dis-enroll mid year (outside of open enrollment), you can cancel your Medicare Advantage plan and go back to Original Medicare. But you will not be able to enroll in a Part D Rx plan until the following January 1. Remember when you cancel a Medicare Advantage plan the prescription coverage cancels also.
- Doctors … Make sure your doctor, specialists and hospitals you wish to have access to, are contracted with the plan you wish to enroll in. Your primary care physician is going to organize all of your care. If you need a specialist, the PCP will refer you to the appropriate specialist within the same medical group. If you wish to see a doctor outside of your PCP’s medical group, this will be quite tricky since your PCP is the one who refers you. If you wish to change your Primary Care Physician, you can do this anytime of the year, and the change to the new doctor will take place the first of the following month after the change is made.
Some Medicare Advantage plans can work pretty will, and then there are some that will not help much. Be careful when comparing benefits along with doctor and hospital access.
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