Every September, Medicare Advantage enrollees receive the Annual Notice of Change that highlights all of the changes that your insurance carrier has made to your plan, including to hospital or doctor networks and other important variables.
Sometimes it will list the changes and a specific plan is being discontinued, forcing you to look for a new plan.
Even if you like the plan you have now, you should take the time to read the change notice to make sure that it still contains what you need. If there are no changes to your plan, you may still benefit from taking a look to see if you can get a better deal or better coverage with another plan.
If you decide to change plans, there are a number of factors you should consider to ensure that you choose the one that’s right for you.
If you are choosing a new plan, there are five basic areas that you should focus your homework on these areas, according to Consumer Reports magazine:
Star ratings
Medicare uses a star rating system to measure health plan quality on a scale of 1-5. The ratings are based on the quality of the care that’s available under the plan as well as customer satisfaction. The star ratings are a good guide and if you go with any plan with 3.5 or more stars it should meet your needs.
Also, 4- and 5-star plans also receive additional government funding to spend on enrollees’ health care.
Skin in the game
The next area you should look at is the out-of-pocket expenses of the plan, like co-pays and deductibles.
The key things to look for here are the out-of-pocket limit, which is the uppermost amount that you would have to pay out of pocket in any given year.
If the amount sends shivers down your spine, you may opt for a plan that has a lower maximum but may cost you a bit more in your monthly premium.
Participating doctors and hospitals
This is also another biggie. Most people want to keep their family doctor so you’ll want to peruse the plan’s list of providers.
Typically, if you opt for a doctor who’s not in the network, the insurer unlikely to not cover the cost or pay very little.
TIP: If keeping your doctor is one of your primary concerns, you should call their office and ask which Medicare Advantage plans they participate in.
Dental and vision coverage
Dental and vision are now part of some Medicare Advantage plans and if this is important to you, you should see if one of the plans you’re interested in covers these added benefits.
Vision coverage is especially important as the doctor can detect early warning signs of serious diseases during a routine eye exam.
Poor coverage while traveling
Many plans will only pay for emergency care when you are away from home.
So this could be an issue if you don’t stay put all year. Say you’re on the road in your motorhome much of the year and you have a medical issue. Chances are that if you’re not in your home state, you’ll be out of network for non-emergency health care.
A few plans have national networks you can use. Talk to us if this is something that’s important to you. We can look for plans that have national coverage.
