Many people choose a plan when they first enroll in Medicare and then never look back. They simply stay with the same plan year after year. In general, Medicare Advantage and Part D plans automatically renew every year if you don’t take any action. Automatic plan renewal may make it easy, but it still makes sense to review your current plan benefits. Coverage and costs may change from year to year, as can your health care needs.
However, just letting your plan renew may be a mistake. The Medicare Annual Enrollment Period (AEP), October 15 through December 7, is your chance to review your current Medicare coverage and, if you find it doesn’t fit right anymore, shop around.
You should receive an Annual Notice of Change letter (ANOC) from your Medicare Advantage or Part D plan every fall. The ANOC details your plan benefit changes for the upcoming year. Be sure to review it to learn what your coverage and costs will be.
Even if you are happy with your plan, here are some reasons why you may want to shop around for a different plan. The associated questions could also help you decide if you have a good reason to do so.
1. Save Money
Your plan may be good, but it may also be expensive. It never hurts to look around to see if you can get the benefits and coverage you want and save some money.
- Have your current plan’s costs changed?
- How much are your plan premiums?
- What deductibles will you owe?
- What co-pays and coinsurance amounts will you be responsible for?
- Will you be covered for the health care services you usually use?
- What planned surgeries or other health care services do you need to consider?
- How much did you pay this past year in health care costs?
2. Use Your Preferred Doctors, Pharmacies and Hospitals
Your health is personal, and for many people it is important to use the doctors and providers that you are comfortable with. Medicare Advantage and Part D plans can have networks in which only certain providers or pharmacies are covered, and these can change every year. Evaluate if the health care professionals you need and want to see are still going to be covered the same way.
- Are your doctors or other providers in your plan network?
- Are you willing to choose a different doctor to stay within a plan network?
- Will it cost you more to see your providers next year versus this year?
3. Manage Your Medication and Prescription Drug Costs
Medications can add up. And the more you take, the more you could pay down the line. Consider the following questions and think about how you can better manage your overall prescription drug costs.
- Are the prescription drugs you take on your plan’s formulary? In which tiers?
- What will your co-pay be when you fill a prescription?
- Will your co-pay be different for generic versus brand-name drugs?
- Has your doctor recently prescribed any new medications for you?
- Have you recently stopped taking any prescription drugs?
- Does your current plan offer any programs or benefits to help you cut costs on drugs like mail-order pharmacy reduced rates?
4. Fit Your Medicare Plan to Your Health Needs
Your Medicare coverage should cover all the health care services and items you need in a year. And because your health can change quickly in a year, it’s important to evaluate the following questions about yourself and see how your plan holds up.
- Have your medical needs changed in the past year?
- Do you have new health conditions?
- Does your current health status work with your current Medicare plan?
- What personal and financial life changes have occurred in the past year?
In the end, the choice you make during the Medicare Annual Enrollment Period is up to you. You can stay with your current Medicare plan. You can switch to a new one. No matter what decision you make, so long as it’s right for your health, that’s all that matters.