by Barbara Nevins Taylor
In the bewildering array of Medicare choices, Medicare Advantage stands out and seems to work well for the nearly 30 million Americans who chose to sign on to one of these plans. But plans vary, and change from year to year, and it pays to shop around. The Open Enrollment period in the fall gives you the chance to do just that.
Mitchell Clark of the Medicare Rights Center says, “If there’s one mantra for the open enrollment season, it’s “review your options.” We advise people with Medicare to carefully consider how they get their Medicare benefits.”
From October 15 to December 7, 2015 you can switch your 2016 coverage in a Medicare Advantage plan also known as Medicare Part C. Keep in mind, loyalty doesn’t pay off in the medical insurance world. Insurers change-up their offerings every year and that’s why it pays to compare plans every year even though you wish you didn’t have to do it.
The booklet called “Annual Notice of Changes,” you should have received from your insurer will tell you what the insurer will charge for co-pays, fees and which prescription medication(s) it will include.
You have the chance to pick a cheaper plan, one that more of your medical providers accept, or one that offers the medication(s) you need and more benefits.
WHAT MEDICARE ADVANTAGE OFFERS
Medicare Advantage typically includes a lot of extras including vision, dental, and wellness programs including gym memberships and some include prescription drugs.
You pay the regular Part B premium of $104.90 a month and then you want to compare prices. Insurers have different requirements. Some may charge a monthly premium and others may charge different fees.
You do want to make sure that you pick a plan that works for you. Medicare Advantage comes in several forms with different options. You can choose:
A Health Maintenance Organization, or HMO – It will require you to choose doctors and providers from a specific network and you must get a referral to see a specialist.
A Preferred Provider Organization, or PPO – You pay less if you use doctors and hospitals in the insurers network. And you pay more for those you use out of network.
A Private-Fee-For-Service plan, or PFFS – You can go to any doctor or hospital as long as they accept the plan’s fees and the plan determines how much it will pay.
WHO SHOULD USE MEDICARE ADVANTAGE
Experts say a Medicare Advantage program can work for you if the doctors, hospitals and medical providers accept the insurance, and if you don’t travel often. Generally, the plans do not cover doctors out-of-state or out of the country.
HOW TO FIND A PLAN
Medicare.gov offers a tool that will help you compare the plans available to you. It also provides ratings for plans and gives a plan one to five stars based on what it offers and how it actually works for consumers.
You can also call Medicare directly at 1-800-633-4227 and say “agent” if you need additional help.
Insurers also compete for your business and offer seminars and community meetings where you get to ask questions.
Medicare Rights Center‘s Mitchell Clark offers this last bit of important advice: “If you decide to enroll in a new plan, we advise you to do so by calling 1-800-MEDICARE rather than the plan itself.” That way you can get additional information you may need.