Top 5 Questions to Ask Yourself During Medicare Open Enrollment

Find the Medicare Plan That is Right for You

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Open Enrollment is a time for you to stop and reflect on your health. Ask yourself these questions and you may be better able to find a plan that works for you.

1. Did your health change during the past year?

If you have been newly diagnosed with a condition, you may need more health coverage. Will more doctor visits be required during the year? More testing? More medications? In this case, you may want to consider Medicare plans that cover all of these possibilities.

 You should speak to your healthcare provider to discuss expectations.

2. Did you review the Annual Notice of Change form from your current Medicare Advantage or Part D plan?

Your current health plan may make changes in the coming year. The plan is required to send you a formal notice outlining those changes. You will usually receive the Annual Notice of Change form in September. Premiums or deductibles could increase. Services could be cut or added. If you have a Part D plan, the medication formulary could change, possibly no longer covering all of the medications you take. With these changes, your plan may not be as cost effective for you as it had been the previous year. It is worth taking the time to shop around for a plan that will work better for you.

3. How much money did you spend on health care last year?

Add up all your healthcare expenditures over the past year. This should include the costs of premiums, deductibles, copayments, coinsurance and other out of pocket expenses.

You can use this number as a gauge as to how much you may spend in the coming year. If you felt your costs were unmanageable last year, you should try to find a plan that helps to budget you below those costs. It is in your best interest to do this regardless.

4. Do you need more healthcare services than what Original Medicare offers? 

You may be surprised at what Original Medicare (Part A and Part B) does not cover.

There will be no coverage of corrective lenses (eyeglasses or contact lenses), dentures or hearing aids. You will have to pay out of pocket for dental, hearing and vision screening exams. You may be left to pay for healthcare during foreign travel. A Medicare Advantage plan may offer extended coverage, offering more services that you need. If you anticipate a specific medical need not covered under the Original Medicare benefit, you may want to investigate what a Medicare Advantage plan can offer you.

5. How do you find a quality Medicare plan?

Medicare has set up a five-star rating system for Medicare Advantage and Part D plans. The five-star rating takes into account customer service, member complaints and member experience with the plan, including whether or not members choose to stay with the plan. For Medicare Advantage plans, it will also consider preventive care offerings, i.e. screening tests and vaccinations, and how well a plan helps to manage chronic medical conditions. If a plan has a low star rating, it could be frustrating to deal with that insurance company when it comes time to pay for your services.

You have to weigh what matters most to you, a less expensive plan or a higher rated plan. Hopefully, you can find a plan that meets both of these needs.

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