If you’re covered by Medicare, now is the time to make changes to your health plan and prescription drug coverage. Medicare’s annual open-enrollment period is open until December 7th.
With so many plans to choose from, shopping for a new Medicare Advantage and/or Part D prescription drug plan can seem like a daunting task.
Here are five things to consider when shopping for your Medicare coverage options:
1. NOT shopping can cost you.
Each year, cost and benefit details of Medicare Advantage and stand-alone Part D drug plans change – even if just a little.
Those changes can be costly.
According to a recent survey of 49,000 people using eHealthMedicare.com to compare Medicare plans, people who switched to a new Part D drug plan saved nearly $ 700 in 2015. In addition, they were 20% less likely to hit the prescription drug coverage gap.
The bottom line: Even if you’re happy with your current coverage, shop your options during this open enrollment period to make sure you still have the plan that best meets your needs.
2. Look beyond premiums.
A plan with a low monthly premium may be more expensive in the long run if doctor visits or prescriptions come with high out-of-pocket costs throughout the year.
To get a true sense of what you’re healthcare costs are likely to be, look beyond your monthly premium to understand each plan’s deductibles, co-pays and coinsurance.
3. Make sure your drugs are covered.
Expect to pay more when you fill your prescription drugs next year. Across the board, Part D plan deductibles and other out-of-pocket expenses are rising.
Confirm that the medications you need are covered by your plan. And, check on the details of cost-sharing tiers, which are very common in most plans. Generics on the lowest tiers cost the least, while brand-name and specialty drugs on the highest tiers come with the highest out-of-pocket costs.
Finally, don’t forget to check which pharmacies participate with your plan, and which tiers the plan has placed them on. Prescriptions cost less when you fill them at a pharmacy identified as one offering “preferred cost sharing.” And beware: Not everyone lives near a pharmacy with preferred prices.
4. Is your doctor in-network?
Making sure your doctors participate with your health plan is one of the most important parts of picking the right policy. Out-of-network care can be very expensive. In fact, a recent report by America’s Health Insurance Plans found that out-of-network providers charged patients on average 300% more than Medicare rates for certain procedures and treatments, such as MRIs and chemotherapy.
5. Check star ratings.
Medicare has a quality rating system in which plans are ranked from one to five stars, with five the highest. Try to choose one with no less than 3.5 or 4 stars. You can see a plan’s ratings on the Medicare plan finder at www.medicare.gov or call (800) 633-4227.
You can also get free personalized counseling services through your State Health Insurance Assistance Program at: www.shiptacenter.org or by calling (800) 677-1116.