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Does Your Medicare Advantage Plan Meet Your Needs?

From a physical and financial health perspective, it’s wise to examine your Medicare Advantage coverage each year.

Medicare open enrollment takes place annually from Oct. 15 through Dec. 7. This makes fall a good time to start planning for the year ahead.

The following considerations can help you determine whether your current plan meets your health and financial needs. If not, use the information as a starting point to find a new plan.

Annual notice of change

In September, look for your plan’s annual notice of change. Medicare Advantage and Medicare Part D plans send this notice to announce important coverage information.

The changes listed in your annual notice will be effective the following January. This gives you time to review changes, compare costs and coverage, and explore plan options.

When you receive your annual notice of change, review the following information:

  • Benefits added or removed
  • Monthly premium and cost-sharing amounts
  • Providers in your network
  • In-network coverage
  • Out-of-network coverage
  • Prescription drugs

If you don’t receive your annual notice of change by Sept. 30, contact your plan. They are required to send this notice each fall.

As you consider your coverage options, answer the following questions about your personal health, financial standing, and plan satisfaction.

Personal health

  • Does your Medicare Advantage plan meet your current health needs?
  • Are you anticipating new health concerns or the need for additional coverage? For example:
    • Should you add dental or vision coverage?
    • Will you be taking new prescription drugs?
    • Does your doctor recommend any surgeries or other medical procedures for the year ahead?
    • Does your family history suggest an increased risk for certain health conditions?
  • Will the plan changes described in the annual notice affect your ability to meet your health needs?
  • Will your doctors and health care providers remain in network?
  • Will your plan continue to cover your prescription drugs?

Financial standing

  • Do monthly plan premiums fit your budget?
  • Will anticipated deductibles, copays, coinsurance, and out-of-pocket limits fit your budget?
  • Is your current financial standing stable?
  • Are there financial challenges that could limit your ability to pay for medical needs this year? For example:
    • Will you be moving to a new geographic location?
    • Do you expect to travel extensively or out of the country?
    • Are you facing financial challenges from a job loss, a change in marital status or investment choices?
  • If your budget is stretched, are there options to help you pay for Medicare costs?

Plan satisfaction

  • Is your plan responsive to your needs?
  • Do you have 24/7 coverage for questions and services?
  • Can you access information and resources online?
  • Is there a rewards program for completing healthy activities?
  • Are there discounts for prescription drugs, such as mail-order options or 90-day supplies?

Reviewing your options

With your answers to the questions above, you can find a plan that meets your needs.

For more information, talk with your benefits adviser or Medicare broker. They can help you review plan options, costs, and coverages.

By Applied Systems, Inc.

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