What should you think about it?
While you may not have many Medicare Advantage options if you reside in a rural region, city dwellers may have two dozen or more possibilities. Use the following ways to narrow the field:
Locate the star rating. Medicare gathers information about Medicare Advantage plans from member surveys, the plans themselves, and health care providers and then assigns a star rating based on its results. “It’s based on performance on a variety of different quality metrics, such as ‘How responsive is the plan to any concerns or questions?'” says Anne Tumlinson, CEO of health care research and consulting firm ATI Advisory. The star rating ranges from 1 to 5, with 5 being exceptional.
Examine the figures. The premium for a plan and the maximum out-of-pocket cost, which is the most you’ll pay in a year for covered health care, are the two key cost concerns. Maximum out-of-pocket expenditures are typically between $3,000 and $7,550, with higher premiums for plans with lower out-of-pocket maximums.
Consider your medications. You can enter your usual prescriptions into the plan comparison tool on Medicare.gov and some private comparison sites to assess plan coverage and cost.
Please make a list of your healthcare providers and cross-reference them. If you have a regular network of caregivers and medical institutions, you’ll want a plan that covers them all. However, it is your responsibility to determine whether the doctors, specialists, and facilities accept the specific Medicare Advantage plan you are considering.
Consider your preferences. If you see specialists regularly and do not require a referral for each office visit, a PPO plan is a better choice than an HMO. On the other hand, if you use health care only infrequently and mostly see your primary care physician, an HMO may be more cost-effective.
Visit the webpage for the plan. Before committing to a plan, visit the provider’s website to ensure you understand all of the perks — and limits. “What we’re seeing is that plans are introducing new and unique advantages, such as in-home palliative care,” Tumlinson says. Those are exciting, and if you need them, they are something to think about. However, these additional benefits are frequently limited, so double-check the plan.
Contact the carriers. If you’re considering enrolling in or moving to a different plan, contact the provider directly to ensure that all of the specifics match what you see online.
When will you be able to sign up?
During the following times, you can enroll in a Medicare Advantage plan (or switch from one to another):
During the first few weeks of your enrollment.
Every year from October 15 to December 7, during open enrollment.
During Medicare Advantage open enrollment, which runs from January 1 to March 31, you can switch from one Medicare Advantage plan to another (but you can’t enroll in a Medicare Advantage plan if you don’t already have one).
You will be automatically unenrolled from your old one if you transfer plans when your new one begins.
If you have any questions regarding the process, call Medicare at 800-MEDICARE (800-633-4227), or visit Medicare.gov.