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Network limits, changing medication tiers, cheaper coverage alternatives and richer benefits are reasons to change plans while you have the opportunity
Reviewed by our health policy panel.
Avoid these costly mistakes during Medicare open enrollment
Today medicareresources.org released tips to help consumers avoid costly mistakes while evaluating and selecting coverage during Medicare open enrollment.
Medicare Heads Up: April 24, 2020
In this edition; Medicare trust fund may be at risk due to the coronavirus; Trustees expect continued Medicare Advantage enrollment growth; Medicare Advantage home care benefit could support more beneficiaries in 2021; Social Security is allowing Americans to fax their Medicare enrollment forms; Medicare will pay more for some coronavirus lab tests; CMS is allowing freestanding hospitals in some states to bill Medicare and Medicaid; CMS allows new appeals flexibility; Medicare Advantage plans to get pay boost in 2021; CMS asks Medicare Advantage and Part D insurers not to disenroll certain members
Four signs you need to change your Medicare Part D coverage
Some Medicare beneficiaries stick with the same MA-PD or Part D plan and do well with it for years. But before you settle for your current prescription drug plan, shop around and assess your choices.
Important Medicare enrollment dates
Enrollment dates for Medicare are critical. Missing an enrollment date could cost you higher premiums down the line — or it could cost you coverage entirely.
Is Original Medicare coverage enough?
If you shun private coverage, can you get by on Original Medicare without purchasing supplemental coverage (Medigap and Part D prescription coverage) or using a Medicare Advantage plan?
If you’re enrolled in a Medicare Advantage plan and you’re not happy with it, you do have opportunities – including Medicare open enrollment – to switch out of that coverage each year. But do you need to switch?
One downside to Medicare Advantage is that unlike Original Medicare, it limits you to a specific network of providers. If you have a trusted doctor or facility that’s no longer considered in-network, it pays to find out if there’s an affordable alternative that allows you to continue seeing the providers who know your medical history and make you the most comfortable.
If a medication you take regularly has recently moved from a lower tier to a higher tier under your Advantage plan, then that could be reason enough to switch. This especially holds true if your prescriptions land you in a specialty tier – the most expensive option on the table for brand-name drugs, and, occasionally, generic drugs as well.
Maybe your Medicare Advantage plan didn’t get more expensive from the previous year, or reclassify your medications so that they cost more. But that doesn’t mean there’s not a cheaper option available.
Medicare has a comprehensive Plan Finder you can use to search for Advantage plans in your area and compare them by premium and drug costs. If, in the course of that search, you see that there’s a less expensive plan that offers equivalent coverage to what you have now, switching could be a huge money-saver.
One big reason so many seniors opt for Medicare Advantage over Original Medicare is to gain access to additional benefits the latter won’t cover. But if your current Advantage plan doesn’t offer the perks you’re after, then it pays to look into finding a new one.
Between 2021 and 2022, the number of Medicare Advantage health plans offering supplemental benefits grew in 35 out of 41 categories. Vision services were offered by 97% of plans, while 94% offered hearing and fitness benefits, and 91% offered dental care. If your plan doesn’t offer these features, finding one that does could save you money.
There are plenty of good reasons to move from one Medicare Advantage plan to another, so if you’re currently enrolled in Advantage, you have from January 1 through March 31 each year to change your coverage.
Remember, too, that if you’re unhappy with your current plan but can’t find a suitable alternative, there’s always the option to revert back to Original Medicare and sign up for a Part D plan. This especially holds true if you’re traveling more often that you initially anticipated, and you want the option to see a doctor pretty much anywhere in the country.
(Before switching back to Original Medicare, be sure to check whether you’re able to purchase a Medigap plan to protect yourself against Medicare’s out-of-pocket costs. Original Medicare alone doesn’t come with an out-of-pocket spending limit for health services.)
Maurie Backman has been writing professionally for well over a decade, and her coverage area runs the gamut from healthcare to personal finance to career advice. Much of her writing these days revolves around retirement and its various components and challenges, including healthcare, Medicare, Social Security, and money management.