6 Great Reasons to Give Your Medicare Plan a Check-Up
Even if you don’t expect to change your insurance coverage, reviewing your current coverage now is nothing short of brilliant.
Even if you don’t expect to change your insurance coverage, reviewing your current coverage now is nothing short of brilliant. “Open enrollment is a fantastic opportunity,” says Adrienne Muralidharan, senior Medicare specialist for the Allsup Medicare Advisor, a private, fee-based plan-selection service that helps Medicare beneficiaries choose plans. “Choosing the best plans for you could save you hundreds or even thousands of dollars a year.”
Yet only 30 percent of Medicare beneficiaries review their plans during open enrollment, and even fewer make adjustments. “Some people stick with what they have because they really like it, others because it’s familiar,” Muralidharan says.
Whatever the reason, there are many more why you should take a second look. Here are six.
1. Your health, your budget, or your address may have changed in the past year.
A new medical diagnosis, new medications, a change in your finances, or a move—making access to in-plan doctors and pharmacies difficult—all affect how well your current plan meets your needs.
2. Your current Advantage plan, drug coverage, or Original Medicare isn’t working as well as you expected.
Maybe you’re spending more than you anticipated on premiums, deductibles, or co-pays. Perhaps you’re having trouble finding convenient doctors or specialists, or realize a medication you need isn’t in your plan’s formulary (list of covered drugs). In these cases, you may do better with another plan.
3. Your current plan could be reducing benefits, increasing costs, or even dropping drugs you take from its formulary next year.
Don’t be caught off-guard! Experts say it’s wise to expect premiums and plan co-pays to change from year-to-year. Doctor networks and drug formularies—which determine which drugs a plan covers and how much you’ll pay for them—are often tweaked as well. This could have a big impact on what your health care will cost next year.
4. Your plan won’t be offered in your area next year.
Most years, 95 percent of Medicare users can stay in their current Advantage or prescription-drug plans if they choose. But in 2010, 660,000 Medicare beneficiaries had to find new ones because their Advantage plans, mostly the type called private-fee-for-service plans, were shutting down. Muralidharan said she doesn’t expect as many closures this time around. But if you’re notified that your Advantage plan is closing, you must choose a new one or you’ll automatically be enrolled in Original Medicare.
5. Your doctor, specialist, or preferred hospital no longer accept your plan.
In 2010, the American Medical Association reported that 31% of primary care doctors were restricting the number of Medicare patients they take. One in seven didn’t participate at all, double the rate just seven years previously. In some areas of the country, finding specialists who accept Medicare Advantage plans may be difficult, too. And even a few hospitals have stopped accepting some plans. If this is happening to you, a new plan with more providers close to home might be a smart choice.
6. You just want to be sure you’ve got the best plan.
Eight out of ten Medicare recipients say they’re happy with their current plan. You may be, too. But not comparing features could mean you’re missing out on something better!