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Costly mistakes to avoid when choosing a Medicare Advantage plan – The Mercury News



Medicare offers many choices, and open enrollment is the time to reevaluate your coverage. In doing so, it is a good idea to forego assumptions and make sure your choices aren’t unnecessarily costing you money you could save by choosing differently.

Here are five common mistakes you don’t want to make as you decide among the Medicare options, with open enrollment taking place from Oct. 15 to Dec. 7.

1. Don’t allow automatic plan renewal to make your choice for you.

On Jan. 1, your Medicare Part D (drug plan) or Medicare Advantage plan will automatically renew unless you choose a new plan. Automatic renewal may make your life easy, but it might not be the best way to make your Medicare decisions. This is especially true if your health care needs have changed in the last year, if you are taking more medications, if you have wished you’d had more benefits such as dental or hearing, or if your finances have changed. Those are just a few of the considerations. Plans may also change what they cover annually, including what you will pay in deductible, premium, co-pay or co-insurance amounts. This information will be in the Annual Notice of Change, mailed to patients in September.

2. Don’t ignore your plan’s Annual Notice of Change.

The letter mailed to you by your current plan explains any changes in your plan benefits and costs for the upcoming year. The changes may affect your health care and your budget, so it’s important to read the notification, as it can help you decide early whether to keep your current plan or alert you to look for a new one during the Open Enrollment period, which runs Oct. 15 through Dec. 7.

3. Don’t base your plan choice on the premium alone.

It is easy to focus only on premiums when examining Medicare costs, but it’s also a good idea to consider the big picture. A plan could have a low monthly premium but charge a medical or prescription drug deductible or have higher co-payments. You might prefer this if you rarely go to the doctor and don’t take many medications, but a plan like this could be expensive if you use health care services often, even with the low premium. It’s important to think, too, about all the out-of-pocket costs as well as your healthcare needs when choosing a plan. For example, many Medicare Advantage plans offer routine vision, hearing, and dental coverage, and certain plans also provide fitness membership benefits at no additional cost.

4. Don’t pick a plan because your spouse, relative or friend has it.

You might count on a friend’s word when deciding what new restaurant to try, but a Medicare plan is a personal choice. You want to choose a plan that fits your needs.  You will probably have several plans to choose from, so it’s a good idea to look at all your options, keeping your healthcare needs and budget at the forefront of your mind. The Medicare.gov website suggests considering seven things when choosing a plan that’s just right for you: cost, coverage/benefits, any other coverage you hold, prescription drugs, doctor and hospital choice, quality of care, and travel coverage.

5. Don’t assume you don’t qualify for help with Medicare costs.

Several programs offer financial assistance with Medicare premiums and other costs. In some cases, Medicare Savings Programs may pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, co-insurance, and co-payments if you meet certain conditions. There are four kinds of Medicare Savings Programs: Qualified Medicare Beneficiary (QMB); Specified Low-Income Medicare Beneficiary (SLMB); Qualifying Individual (QI); and Qualified Disabled & Working Individuals (QDWI). If you qualify for one of these programs, you automatically qualify to get extra help paying for Medicare drug coverage. You may want to look into them, even if you think you might not be eligible.

Source: WellMed and Optum

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