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.
Table of Contents
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, and consider if Medicare Advantage Plans or traditional Medicare best meets your requirements. If you have chronic conditions, look into specific plans that provide comprehensive coverage for ongoing treatment. Medicare Prescription Coverage is another important aspect to consider, especially if your treatment involves regular medication.
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. Medicare premium comparison can help you decide if the lower premiums come with higher costs elsewhere.
3. Understand Medicare Coverage Areas
Medicare is divided into sections depending on the purpose of the insurance need. These sections are:
- Hospital: Hospital insurance covers stays in the hospital, hospice, and nursing facilities.
- Medical: Medical insurance provides coverage for outpatient care, physician services (not all services are covered), medical equipment, and preventative care.
- 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.
- 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. Choosing the right Medicare Plan based on these categories is crucial to cover your medical needs effectively.
4. Evaluate Provider Networks
The Medicare 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. Selecting the right network can significantly affect your access to care and overall health outcomes.
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. Reviewing Medicare supplement benefits can help determine if the extra coverage is beneficial for your situation.
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.
Medicare Plan selection should take into account Medicare out-of-pocket costs, Medicare premium comparison, and the specifics of Medicare provider networks. 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.
