It’s that time of year again. And no, we aren’t talking about Black Friday or Cyber Monday? It’s the Annual Election Period (AEP) for Medicare which runs until December 7. I know, reviewing your coverage probably isn’t on your to-do list for the holidays. Just think of it as a special gift you get to pick out yourself. The open enrollment period is a chance for a do-over if you don’t like the plan you have or if it no longer fits. What changes you can or decide to make will depend on the type of Supplement coverage you have, whether it’s Original Medicare (Part A and B) or a Medicare Advantage Plan (Part C) from a private insurer. Here are 5 things to consider to help you decide if your current Medicare Supplement coverage is right for you (or a loved one).
1. What are my true medical needs?
This might seem like an obvious question, but how’s your health? It is important to review any plan details to find out what you’re actually getting, or perhaps more importantly aren’t getting, compared to your medical needs. Someone who is fairly healthy and mostly engaged in preventive care practices is in a different situation than someone who might have a serious on-going medical condition requiring more intensive treatment. Your situation can change over time; plan benefits can change from year to year as well.
2. Does my doctor or hospital accept my plan?
It is important to know if the doctor you would like to see will accept your coverage. But also just as important is knowing that you will be able to get the care you need at a hospital or other treatment facility. Basic Medicare only covers certain procedures or may pay only a portion of a medical procedure, and this can affect the treatments and procedures that medical professionals may recommend. You also may not need extra coverage for certain medical procedures.
3. Do I need drug coverage?
If you have a private health policy, or carry other prescription drug coverage, you may not need a Medicare prescription drug plan (Part D). If you do decide you need the coverage, look at the options in light of what you need. What are your current out-of-pocket costs for prescriptions? Do you take expensive medications?
4. Do I really need coverage for some things?
Have you dreamed of the day you could take off to see the world? If so, you may consider travel coverage. Medicare supplement plans (Part F, G, etc.) sold by private insurance companies can help cover costs Original Medicare doesn’t, but the costs for these plans vary widely and it pays to shop around. Depending on your circumstances, you may be over-insuring by choosing this type of coverage. It may be more cost effective to simply set that money aside.
5. How much premium can I afford?
How much are you currently paying for plan premiums, out-of-pocket expenses and copays? Every insurance company has to offer similar benefits for Medigap insurance, but they can, and do, charge different premiums for the same coverage. Some Medicare Advantage plans may not be much more costly than the premium for Original Medicare, and may cover some additional routine care expenses (like vision, dental or wellness programs). Many include prescription drug coverage. On the other hand, such plans can also have higher premiums, different provider networks, and out-of-pocket limits. Consider the long term; what’s your tolerance and capacity for financial risk and how does that fit with your Medicare plan?
You only have until December 7th to review the coverage you have and elect something different, if what you have isn’t working for you. If you don’t have the time to review it now, the good news is that you will only have to live with it for one more year before you have another opportunity.