Now is the time of year when Medicare beneficiaries can review their options to determine if they should switch from a Medicare Advantage Plan (MAP) to Traditional Medicare (or visa versa) or change Medicare Part D prescription drug plans. One important thing to remember is that you do not have to make any changes if you are satisfied with your current coverage. Unless you receive correspondence from your current insurance carrier stating otherwise, your plan’s benefits will continue.
From now until December 7, beneficiaries can review their current coverage and make changes if they feel a new plan would be more beneficial. By now individuals should have received correspondence from their current insurance carrier providing information stating what the new premium will be, which doctors/pharmacies are participating in the network and if any prescriptions have been removed from the list of covered drugs.
If you are looking to switch from Traditional Medicare to a MAP or switching from one MAP to another MAP, here are a few items to consider:
• Are ALL my doctors and facilities participating in the plan’s network – don’t forget to research skilled nursing homes
• What is my total potential annual out of pocket amount
• If I travel, how will the plan pay for emergency services
• If I am a seasonal resident with a residence in to two different states/counties, how would the plan pay in each location
If you want to change to a new prescription drug plan or purchasing a new plan for the first time, these items should be considered:
• Is my pharmacy in the plan’s network
• What is the difference in copayment amounts
• Are all my prescriptions covered under the plan
• If I have to go to a Skilled Nursing Facility, are my prescriptions covered
• What is my overall out of pocket expense for the year
Many will receive an over abundance of correspondence from insurance carriers explaining why one should sign up with their plan. Make sure careful thought is given before any changes are made. Except for special circumstances, once you sign up for a new plan you are locked into that plan for the year. Always remember to be a smart shopper and carefully evaluate what is available to you. Remember, if you are happy with your current coverage you do not have to make any changes.
These are only a few tips to consider on such a complex issue. If you or a family member need guidance about the choices available, please call our office to speak with one of our knowledgeable staff.