8 Tips for Selecting a Medicare Plan

Scripps is offering free Medicare presentations this fall

Scripps is offering free Medicare presentations this fall

Oct.15 marks the start of the open enrollment period for Medicare, and your mailbox is likely filled with information from insurance companies about your coverage choices. The sheer amount of information can be confusing and even overwhelming.


The following tips should help you make sense of it all – and help you make the right decisions. You’ll have until Dec. 7 to finalize your choices. In most cases, this is the only time you can pick a new Medicare Advantage or Medicare Part D plan.


Now is the time to think about what you need from your Medicare plan and research your available options to make sure you’re getting the most from your benefits.

1. Decide which services are important to you

 “No two people have exactly the same medical needs,” says Marc Reynolds, corporate senior vice president payer relations at Scripps Health. Even if you both have diabetes, for example, you may take different medications, or have other health conditions that affect your care. Make a list of the medical services that you absolutely need, including:

  • Primary and specialty care
  • Specific physicians or hospitals that you prefer
  • Prescription medications
  • Care while traveling or other services

2. Consider your unique needs


Make sure your plan provides the coverage you need at a cost you can afford.

Factors to consider:

  • Premiums, coinsurance, co-payments and deductibles
  • Out-of-pocket limits
  • Quality of care


3. Review your plan and check for any changes in 2017


Before open enrollment begins, your current insurance provider will send an Annual Notice of Change/Evidence of Coverage to let you know about any changes that may be made to your Medicare plan starting in 2017. Read this information carefully.

Changes may include:

  • Costs (premiums, deductibles, co-pays, out-of-pocket)
  • Covered services, provider, hospitals and prescription medications
  • Rules for eligibility


4. Choose the plan that best meets your needs


You may find that your existing Medicare plan will provide everything you need, and you don’t need to make any changes. However, if your current plan doesn’t fit your needs, your options may include switching Medicare Advantage Plans, returning to Original Medicare and making changes to your prescription drug coverage.


5. Check with your employer before making changes


If your employer or union provides your health insurance benefits, you may need to get approval to change your coverage. If you don’t get approval, you may risk losing coverage for yourself as well as your dependents. Before you make any changes, check with your benefits administrator.


6. Remember key dates and differences among enrollment periods


Once you have decided on a Medicare plan, complete the enrollment process. You may be able to do this in person with your agent, online, through the mail or by phone.

Remember, there are different time periods for enrolling in Medicare, dis-enrolling from Medicare Advantage and other actions, says Reynolds. Mark your calendar with the dates and deadlines that apply to you.


7. Take advantages of benefits your plan offers

In addition to caring for you when you are sick, Medicare coverage offers a number of benefits to help you stay well. Once you’re enrolled, take advantage of all your plan has to offer, such as:

  • Annual wellness exam
  • Health advice and referrals
  • Flu and pneumonia shots
  • Education and discounts


8. Ask questions, understand all your options


“Medicare has a lot of options and rules, and it’s easy to get confused between Original Medicare, Medicare Advantage, and Medicare Supplemental Insurance (Medigap),” says Reynolds. “Before you make a decision, be sure you understand everything you need to know. Ask your insurance representative or another trusted source who is knowledgeable about Medicare.”


You also can find information online, but be sure to verify that information -- especially if you are changing doctors. Call the doctor’s office and confirm that he or she is in the plan you want.


Scripps Health is offering several free Medicare presentations throughout San Diego County during October, November and December to explain your options and answer questions. Medicare experts, including representatives from health plans, will be available to answer questions.

See the full schedule by visiting: Get the Most Out of Medicare.