For some people, October symbolizes the start of autumn. But for anyone eligible for Medicare, the arrival of fall means something much more important—Medicare Open Enrollment season. In the following article, HealthMarkets reviews tips and important information to help you pick the right Medicare plan to meet your needs.
You don’t need to sign up for Medicare each year; however, you should review your coverage annually.
Open Enrollment for Medicare begins October 15 and continues through December 7. This is the time when you can transfer from Original Medicare to a Medicare Advantage plan or change from one Medicare Advantage plan to another.
Coverage and costs can change each year. You should always take time to review the materials your plan sends you each year, such as the “Evidence of Coverage” (EOC) and “Annual Notice of Change” (ANOC). You should also spend time reviewing your current health and prescription medications to make sure your plan will still meet your needs for the following year.
What are your Medicare Coverage Choices?
There are two main ways to get your Medicare coverage—Original Medicare or a Medicare Advantage Plan.
Medicare Parts A and B, often referred to as Original Medicare, pay for many healthcare services and supplies, but they don’t cover all of your healthcare costs. For example, you pay a deductible for each hospital stay and coinsurance anytime you use the services of a physician or surgeon. Drug coverage is also limited.
Most Medicare Advantage plans have extra benefits that are not covered by original Medicare such as prescription drugs, eye care, and dental care. In return for these extra benefits, people who enroll in a Medicare Advantage plan receive their care though networks of doctors and hospitals chosen by the plan.
How do you know what plan is right for you?
To get the most from your healthcare dollars, you should carefully consider the costs and benefits of all of your plan options. A few questions you should consider include:
- Will my doctors accept the coverage? If not, are there doctors near me who will?
- Will I have to choose hospital and healthcare providers from a network?
- Will I need referrals to visit specialists?
- Will the plan cover me if I get sick while traveling in another state?
- Are my drugs on the plan’s drug list (or formulary)?
- What will my prescription drugs cost?
- Does the plan include the pharmacies I currently use?
- Can I get my prescriptions through the mail?
- Does the plan have a good quality rating?
A HealthMarkets FitScore® could help you find the right Medicare plan. The FitScore works like a grading system for Medicare plans by taking into account your answers to important questions. After entering your preferences (like what medications you take and who your preferred doctor is), the FitScore grades all the available plans in your area based on your needs. The higher the FitScore, the better a plan should fit your needs.
Medicare isn’t part of the Health Insurance Marketplace.
It’s important to understand that the Health Insurance Marketplaces (or exchanges) are a key part of the Affordable Care Act as a way for individuals, families, and employees of small businesses to get health insurance.
However, if you have Medicare, you should not use the Marketplace to make any changes to your health or drug coverage. The Marketplaces are separate from Medicare, and Medicare plans will not be available in the Marketplaces.
Selecting the right Medicare plan to meet your needs can be confusing. For a personal no-cost, no-obligation evaluation of your Medicare options, call HealthMarkets at (800) 488-7621. Or visit HealthMarkets.com to find a local, licensed insurance agent near you. Whether you are new to Medicare or just trying to decide if you should change plans during Medicare’s Annual Open Enrollment, a licensed agent with HealthMarkets reviews your options with you so that you can make an informed decision and select the plan that best meets your needs and budget.