3 Questions to Ask Yourself Annually About Your Medicare Plan

3 Questions to Ask Yourself Annually About Your Medicare Plan

Nov 21 2014

Shopping for Medicare coverage shouldn’t be a painful experience. Unfortunately, that isn’t always the case.

By: Wayne Wilson

The Kaiser Family Foundation has reported that Medicare beneficiaries say shopping for a Medicare plan is a daunting task that they’d prefer not to repeat. That’s why many choose to stick with their current Medicare plan instead of reviewing coverage options during the annual enrollment period, from Oct. 15 through Dec. 7.

Your decision process can be simplified by setting priorities and understanding the implications of key decision points.

Things change throughout the year. Is your Medicare plan still the best fit? Thinking through your insurance options annually is a good investment of time and could benefit your health in the long run.

If you are feeling overwhelmed, there are helpful resources available. Attend one of the face-to-face Medicare information meetings scheduled throughout the state. Or visit websites that offer useful tools that guide you as you sort through the options.

Your decision process can be simplified by setting priorities and understanding the implications of key decision points. The following questions will help you think through what kind of Medicare coverage you want for next year.

Do you prefer a Medicare Advantage or a Medigap plan?

Today about 30 percent of the people eligible for Medicare in Michigan have a Medicare Advantage plan, according to the Kaiser Family Foundation, which is on par with the national average. If you previously had an HMO or PPO plan through your employer, you’ll find similar coverage with Medicare Advantage. And most Medicare Advantage plans include your prescription coverage, too.

Alternatively, Medigap, also known as Medicare supplement insurance, may be the right choice if you are willing to accept higher premium costs as a trade-off for more flexibility with the providers available and low to no out-of-pocket costs. Medigap plans don’t include prescription drug coverage, however, so you will need to purchase a Part D plan separately.

Does the plan’s network include your doctor and preferred hospital system?

If you like your current physician and they are familiar with your medical history, it is likely that you want to keep seeing them next year. But are they still in your network?

This is a key reason to check your Medicare plan annually – options change from year-to-year as insurance companies add and subtract plans from their portfolio, so it is vital to evaluate the network before choosing a plan.

Do you stay primarily in Michigan, or are you a “snowbird?”

Your travel habits should guide your buying decision. Medicare Advantage  plans make sense for those who stay in Michigan or travel for vacation. They offer coordinated care through your primary care provider, and you’ll be covered for emergencies when traveling.

Medigap plans, on the other hand, generally have no network limitations. So if you prefer to enjoy your winters in a warmer climate, away from the chilly temperatures of Michigan, then a Medigap plan might be the best fit.

Whether you choose to stick with your existing plan or make a new decision for the new year, it’s always a good idea to ask yourself these three questions about your Medicare plan annually. With dozens of Medicare options available in Michigan, no one should make the assumption that their current Medicare plan is the right choice for 2015. Researching coverage choices will help you maximize your financial investment and make sure you get the care you need.

About the Author: Wayne Wilson is vice president of Senior Products at Priority Health. He oversees the company’s Medicare program including strategic direction, product and market development, sales, operations and medical management, for all Medicare products. 

Priority Health has HMO-POS and PPO plans with a Medicare contract. Enrollment in Priority Health Medicare depends on contract renewal.       4000_4009_37 CMS-accepted 11112014