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5 Tips for Choosing the Right Health Insurance Plan During Open Enrollment (Medicare)

5 Tips for Choosing the Right Health Insurance Plan During Open Enrollment (Medicare)

The complex Medicare landscape makes enrollment a daunting process. There are so many options to consider, each with its own medical and financial implications. Whether you’re new, or reassessing a current plan, the Open Enrollment Period (OEP) offers an opportunity to enhance coverage.

Open enrollment begins each year on October 15th and runs until December 7th. During this time, you can review your current Medicare coverage and make changes or start a new plan.

In this blog, we’ll cover a few ways to determine the best plan during OEP and how it can benefit you.

1. Assess Your Health and Plan for the Future

Before choosing a plan during OEP, consider your current health needs and plan for the future. Things to consider include:

  • Frequency of appointments with medical professionals (specialists, doctors, etc.)
  • Current prescriptions
  • Required medical equipment (walker, wheelchair, glucometer, etc.)
  • Potential future prescriptions based on your diagnosis
  • Upcoming procedures (including surgeries)
  • Timeline of chronic conditions

Select a plan that aligns with ongoing treatment needs.

2. Look Beyond Premiums

Medicare includes costs beyond the required premiums. In fact, sometimes a premium is just the tip of the iceberg. Look more deeply into the costs involved in each plan, including:

  • Co-payments: Costs of services covered by you.
  • Maximum out-of-pocket costs: The most you must pay each year outside of premiums.
  • Medication costs: Prescriptions aren’t always fully covered under each plan.
  • Deductibles: The amount you pay before insurance kicks in.

Sometimes higher premiums are worth the additional cost for savings in other places. Out-of-pocket costs could outweigh the premium in areas significant to your medical needs.

3. Understand Medicare Coverage Areas

Medicare is divided into sections depending on the purpose of the insurance need. These sections are:

  1. Hospital: Hospital insurance covers stays in the hospital, hospice, and nursing facilities.
  2. Medical: Medical insurance provides coverage for outpatient care, physician services (not all services are covered), medical equipment, and preventative care.
  3. Medicare Advantage: This is an alternative to traditional plans like A and B. It’s often used by private companies looking to diversify medical coverage. Sometimes it includes advanced prescription coverage.
  4. Prescription Drug Coverage: Coverage of prescription costs. This is often offered by private companies to offset the cost of medication for employees.

Your original health assessment will help determine which plan is best for you. The company you work for may also impact which plans are available.

4. Evaluate Provider Networks

The provider network you choose impacts the effectiveness of your Medicare plan choice in many ways, including:

  • Maintaining long-standing relationships with family doctors and trusted medical professionals
  • Avoiding out-of-network costs
  • Aligning with Medicare Advantage plans (these usually have a specified network of medical professionals)

Periodically, networks change. It’s important to check the status of your provider network periodically to ensure you’re covered.

5. Other Advantages and Features

Some of the Medicare Advantage plans through private companies offer supplementary benefits. Some additional features you may select include:

  • Vision care
  • Dental care
  • Hearing services
  • Wellness programs (gym memberships, fitness classes, etc.)
  • Telehealth services

Extra benefits are nice but may not be worth the extra costs associated with these plans. Evaluate the relevance of each extra feature in your life and medical history.

Contact Uncommon Cents Investing

Medicare can be a maze, but every year you get a chance to review and possibly adjust your plan during the Open Enrollment Period (OEP). When diving into this, remember to think about your current and future health needs. Look beyond just the monthly costs, because sometimes paying a bit more upfront can save you in the long run. Know the different parts of Medicare and what they cover, and keep an eye on the doctors and specialists in your network. And, some plans toss in extras like gym memberships or dental care. Before you make a choice, weigh out all these factors. At the end of the day, you want a plan that fits your health care needs without emptying your pockets.

Sheena Hanson, CFP® - Investment Advisor Representative and CCO

More About the Author: Sheena Hanson