Top 5 Questions to Ask Yourself During Medicare Open Enrollment

Find the Medicare Plan That is Right for You

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Medicare Open Enrollment, which takes place from October 15 to December 7 every year, is the perfect time for you to stop and reflect on your health. Ask yourself these five simple questions and you may be better able to find the Medicare plan that works best for you.

1. Did your health change during the past year?

If you have been newly diagnosed with a medical condition, you may need more health coverage.

Will more doctor visits be needed during the year? More blood work and testing? More medications? In this case, you may want to consider a more extensive Medicare plan that covers all of these possibilities. You should speak to your healthcare provider to discuss your medical condition and reasonable expectations for the year ahead.

2. Did you review the Annual Notice of Change form from your current Medicare Advantage or Part D plan?

Your current Medicare plan may make changes in the coming year. The plan is required to send you a formal notice outlining those changes.

You will usually receive the Annual Notice of Change form in September. Premiums or deductibles could increase. Services could be cut or added. If you have a Part D plan, the medication formulary could change, possibly no longer covering all of the medications you take. With these changes, your plan may not be as cost effective for you as it had been the previous year. It is worth taking the time to shop around for a plan that will work better for you.

3. How much money did you spend on health care last year?

Your past healthcare expenditures can give you a gauge as to how much you might spend in the coming year.

All it takes is simple math. Add up all your healthcare expenditures over the past year. This should include the costs of premiums, deductibles, copayments, coinsurance, and any other out of pocket expenses. If you felt these costs were unmanageable or barely manageable last year, you should try to find a plan that helps to budget you below those costs. Unfortunately, due to inflation and annual price hikes by insurance companies, your actual costs will likely be somewhat higher than this estimate. Regardless, this is an important place to start.

4. Do you need more healthcare services than what Original Medicare offers?

You may be surprised at what Original Medicare (Part A and Part B) does not cover.

Original Medicare does not cover corrective lenses (eyeglasses or contact lenses), dentures, hearing aids, or even white canes for the blind. You will have to pay out of pocket for dental, hearing and vision screening exams. You may be left to pay for healthcare during foreign travel too. A Medicare Advantage plan may offer extended coverage, offering more services that you need. If you anticipate a specific medical need not covered under the Original Medicare benefit, you may want to investigate what a Medicare Advantage plan has to offer.

5. How do you find a quality Medicare plan?

Medicare has set up a five-star rating system for Medicare Advantage and Part D plans. Five is the best; one is the worst.

The five-star rating takes into account customer service, member complaints, and member experience with the plan, including whether or not members choose to stay with the plan. For Medicare Advantage plans, it will also consider preventive care offerings, i.e. screening tests and vaccinations, and how well a plan helps to manage chronic medical conditions. If a plan has a low star rating, it could be frustrating to deal with that insurance company when it comes time to pay for your services. You have to weigh what matters most to you, a less expensive plan or a higher rated plan. Hopefully, you can find a plan that meets both of these needs.

A Word from Verywell

Medicare Open Enrollment can be a confusing time for many people. With so many options, it can be hard to know where to turn. Ask yourself these simple questions to see if your current plan is going to meet your needs in the coming year, and do some research to see if another plan could be a better bargain.

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