Medicare annual enrollment period is here, which means you have until Dec. 7 to pick a new Medicare plan for 2020 if you want one. And, even if you’re happy with your plan, many people don’t realize their plan’s benefits can change from year to year. So how do you know if you’ve got the right one?

 

First your health needs, then your plan details

First consider your health. Health history, and frequency and type of doctor visits, will help you identify the best-fit plans. Preventive medicine and screening services are typically covered under Medicare plans, but it’s important to think about additional care you might need in the next year. Medications matter, too. Most Medicare plans offer outpatient prescription drug coverage, called Part D. As you think about your Part D options, check if your drugs are covered by the plans you’re considering.

When you have a good idea about the type of care you’ll need in the coming year, it’s time to explore the Medicare options available to you. 

 

Supplement vs Advantage

In the Northeast Suburbs, many people will consider Medicare Supplement or Medicare Advantage plans.

Medicare Supplement plans have access to any provider in the U.S. that accepts Medicare, meaning there is no network. However, Supplement plans can be more expensive per month and typically require a person to undergo a health evaluation before they can be accepted. These plans cover medical services only, so you will also need to purchase a Part D drug plan if you want drug coverage, and will have to carry multiple cards to verify your coverage with doctors and pharmacies. 

Medicare Advantage plans have the benefit of convenience and simplicity. All of the coverage is within one plan – often with drug coverage included – and one number to call with questions. Many Medicare Advantage plans also have low or zero dollar premiums and extra benefits like dental, eyewear and routine vision and hearing exam coverage.

 

Networks & quality

It’s important to pick a plan that provides coverage at your preferred doctors, clinics and hospitals. Unlike Supplement plans, Medicare Advantage plans can change their network from year-to-year, so it’s important to look up your doctor and confirm they continue to be listed in the directory. 

Beyond network, it’s helpful to consult the recently released Medicare Star Ratings from the Centers for Medicare and Medicaid Services. The agency rates plans’ overall performance in more than 40 areas across nine general categories. 

 

Making the choice

Picking a health plan is very personal, so try talking with someone from the health plan you’re considering. You’ll get a better idea about the organization that will be caring for you and the benefits of its plans. 

 

Sara Wagner

Manager, HealthPartners Medicare & Individual Health Solutions

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