Medicare coverage isn’t a set-it-and-forget-it decision. Medicare plans can change from year to year, and so can your healthcare needs. A health emergency can alter these needs in an instant, and your “perfect” Medicare plan may now come up short.
Reviewing your Medicare plan annually ensures you continue to have the right coverage for your evolving healthcare needs. But how do you determine if you still have the “best” plan? With multiple Medicare parts and plans, plus your current and future health needs to consider, “reviewing” your Medicare coverage can feel overwhelming.
You don’t have to review your plan alone! Wandacare’s expert Medicare Advisors can provide a personalized plan review, helping you navigate the complexities and nuances of Medicare coverage. We’ll walk you through the key factors to consider and the common mistakes to avoid when reviewing your Medicare coverage.
Why You Should Review Your Medicare Coverage Annually
Because Medicare plans are updated annually, you can change or update your Medicare coverage every year. The Medicare Annual Enrollment Period (AEP) is your yearly opportunity to make these changes.
AEP runs from October 15 to December 7 and applies to everyone enrolled in Original Medicare (Parts A and B), Medicare Advantage Plans (Part C), and Medicare Part D prescription drug plans. Any changes you make during AEP go into effect on January 1 of the following year.
While it can be easy to put off reviewing your Medicare plans until the end of the year, you don’t want to wait until AEP to start your review. Changes to your health and even your plan’s network (e.g. you learn your primary care physician is no longer in-network with your Medicare Advantage Plan) can happen throughout the year. Be sure you’re keeping track of these changes so you can be prepared for Medicare AEP.
Key Factors to Consider When Reviewing Your Medicare Coverage
So, what “changes” should you be aware of? Here are the key factors to consider when reviewing your Medicare coverage:
Your Current and Future Healthcare Needs
Evaluating your current healthcare needs, how your needs may have changed in the last year and thinking about your future health needs can help you determine if your plan is still working for you. Look at factors like the medications you’re currently prescribed, how frequently you go to the doctor, and any lifestyle changes that have happened or you have planned (e.g. moving, international travel, etc.). These life changes can affect your coverage and the available plans. And if you do anticipate changes in your health, you should keep that in mind as you review your current plan and compare plans and benefits.
Your Current Plan Coverage
Now review your current plan to ensure it’s still meeting all those healthcare needs. Review all your current Medicare coverage (whether that’s Original Medicare or a Medicare Advantage Plan), including your Medicare Part D prescription drug plan and any supplemental coverage you have. Watch for notifications from your plan provider to stay informed about any changes in your plan, such as an increase in premiums or a change to the services covered.
Changes to Your Plan’s Coverage
In the fall before AEP begins, you should receive the Annual Notice of Change (ANOC) that goes out to all Medicare beneficiaries. Be sure to read it thoroughly. Has there been a change to the in-network provider list? Have premiums, deductibles, copayments, and/or coinsurance increased? Is a prescription drug you’re taking now on a different “tier” of coverage? These kinds of changes can affect your covered benefits and out-of-pocket costs.
Overall Costs and Cost-Saving Opportunities
Changes to your health, plans, and benefits coverage can all affect your costs. If your review reveals that you’re now paying more for your healthcare, look for opportunities to reduce your overall costs. This could mean changing to a plan with lower premiums, copayments, deductibles, and out-of-pocket maximums. Consider assistance programs like Medicaid and Medicare Savings Programs that help cover premiums and other healthcare costs based on income. If you have Original Medicare for your coverage, look at your Medicare Supplement Plan (Medigap) or consider getting one, as this can help you save on future, out-of-pocket costs.
Benefit Usage
Are you taking full advantage of the benefits you’re paying for? Are there new benefits or additional coverage you now need? These are questions to ask as you review your current plan. There may be other plans that offer more benefits or at a better price. Look at premiums, deductibles, copayments, network providers, and additional benefits like dental, vision, and fitness programs, to be sure you’re getting the benefits you want within your budget.
Common Mistakes to Avoid During Your Medicare Plan Review
Reviewing your Medicare plans and care needs regularly empowers you to make informed decisions about your coverage. First, make sure you’re doing an informed plan review by avoiding these common mistakes in your review process:
Ignoring the Annual Notice of Change (ANOC)
Many people assume their plan stays the same or that any changes are minimal, so they ignore the Annual Notice of Change (ANOC) document. Do not make this mistake! The ANOC is your official notice from your plan provider outlining all upcoming changes. Always review the ANOC carefully. Otherwise, you may be surprised by unexpected premium hikes, reduced benefits, or changes to your plan’s network of preferred providers.
Focusing Only on Premiums Without Considering Total Costs
When it comes to determining the cost and savings of a Medicare plan, it can be easy to focus on the monthly premium. However, a lower monthly premium doesn’t always mean lower overall costs. In fact, a low-premium plan typically has higher out-of-pocket expenses. Premiums are just one piece of a plan’s costs, so be sure to also factor in deductibles, co-pays, co-insurance, out-of-pocket maximums, and drug costs. A plan with a higher premium but lower deductibles might save you more in the long run.
Not Reviewing Part D Prescription Drug Coverage and Plan Changes
All Medicare Part D prescription drug plans are offered by private insurance companies. If you have a Medicare Advantage Plan, drug coverage is included. However, if you have Original Medicare, your Part D plan, bills, and communications (like your Annual Notice of Change) are separate. Do not overlook them! Your Part D plan’s drug formulary (the listing of drugs covered and at what price “tier”) can change, meaning your medications may no longer be covered or at a higher cost. Always check that your prescriptions are still on your plan’s formulary. Again, always review all Medicare ANOC documents.
Sticking with the Same Plan Without Comparing Options
Many people assume the Medicare plan they have is the best one for them, so they just keep renewing their current plan. This “if it ain’t broke, don’t fix it” approach to Medicare coverage can be a mistake. Your health needs change. Medicare plans change. Failing to explore other options and compare plans can mean missing out on better coverage and savings.
Not Seeking Expert Help
As you can see, there is A LOT to consider when reviewing your Medicare plan. Many Medicare beneficiaries make the mistake of not seeking expert guidance. A Medicare Advisor can assist in your plan review, clarifying plan complexities and helping you make an informed decision.
Avoid this mistake (and all the rest!) by consulting with the Medicare experts at Wandacare! We’ll review your plan based on your evolving health needs, desired benefits, and any budgetary changes, and then help you compare Medicare plan options to determine the plan that is the best fit for you.
Schedule your personalized Medicare review with Wandacare today!
