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Medicare Enrollment: What You Must Keep In Mind Before Zeroing In On A Plan


Whether you are new or old to Medicare, certain changes keep occurring over time. If you are someone above the age of 60 or 65, a number of vital decisions must be made regarding your health coverage. So, do not wait any longer and make these changes at the earliest to find the most appropriate plan and prescription drug coverage. The most difficult task lies in selecting from the various plans on offer. You can always talk to someone who has undergone these steps or someone who represents the authority to advise you of a plan best suited for your needs. For a better understanding, these are the following considerations to keep in mind when choosing your Medicare coverage options:

Consider Your Options Carefully

Take into consideration cost, coverage, convenience, and customer service before choosing a plan

You might think that once a plan has been purchased, the work is done. Not really! Every year, pricing, benefits, and other such details of Medicare Advantage (and even the Part D drug plans which are standalones) keep undergoing changes. And all these must be known to you, no matter how insignificant the changes might be, for they incur huge costs.

Going by a recent survey involving 49,000 people who have used an online service to compare the plans, anybody who switched to a new Part D drug plan managed to save close to $700 in 2015, and also became 20% less susceptible to ‘hit the prescription drug coverage gap’.

This definitely points to the fact that if the current coverage is satisfactory, the options are also worth a watch during the open enrollment period to ensure that the best plan is chosen.

Compare Until You Are Convinced

Compare Medicare plans thoroughly as the benefits are quite different across the plans

Usually, beneficiaries of Medicare stick to their existing plan and coverage, and act skeptical when changes are likely to happen. But as expressed earlier, some transformations are essential to stay better, and that can only happen if one chooses to stay informed and updated.

Move Ahead Of Monthly Premiums

Any plan with a low monthly premium is likely to be expensive over time if your doctor schedules a visit and/or when prescriptions are available with very high out-of-pocket costs all through the year.

In order to get a basic idea about how much healthcare costs can be, try and see beyond the obvious. In other words, move ahead of the monthly premiums so that you understand every plan’s deductibles, coinsurance, and additional payments.

Are The Drugs Covered?

Examine the drug cost-sharing details of the plan you are choosing

Part D plan deductibles and all other forms of costs are bound to escalate. First, you must confirm that the medications you require are well covered by the plan you have chosen. Also, check on cost-sharing tiers details. For example, the lowest tiers are cheap, but specialty drugs and brand names on the highest tiers can indeed cost you a lot. Also, keep in mind that pharmacies participate within plans. Most prescriptions will be easy on the pocket when filled at a pharmacy recognized as something that offers ‘preferred cost sharing’.

In-Network Doctors Are Much Better

You must see if your doctor participates in your health plan or not. This is one of the chief aspects that you must look for when selecting the correct policy. Out-of-network care involves a lot of cost, so better think of that when choosing your doctor.

You can check the recent report by America’s Health Insurance Plans that found how these out-of-network providers have charged almost 300% more than the normal Medicare rates for other treatments and procedures like chemotherapy and MRIs.

Keep A Tab On Star Ratings

Medicare rating system helps the healthcare consumers in choosing the best plans and services

One of the best aspects about Medicare is that it has a quality rating system wherein plans are ranked from 1 to 5 stars. It is usually recommended that you choose nothing less than 3.5 or 4 stars as that will automatically determine the quality you wish to have.

Almost all the plans are updated on the Medicare plan finder, and you can check for the ratings accordingly, before selection. Aside from that, there are personalized counseling services which are offered free of cost at different centers, so you can always avail of those additional benefits.

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