Medicare Advantage Changes Deadline Is Coming Soon!

Review these Medicare Advantage plan changes to save money and choose the right coverage for you.

Last month, we looked at the upcoming Medicare deadline. As a quick refresher, here’s what you need to remember. The Annual Enrollment Period (AEP) for Medicare runs from October 15 to December 7. This is your chance to make changes to Medicare coverage and potentially save thousands of dollars in 2020.

Last month’s article focused mostly on Original Medicare (Medicare Parts A, B, and D). However, Medicare is complex, and we couldn’t cover everything in one article. Today, we will talk about the other side of the coin: Medicare Advantage (Medicare Part C).

All those parts can get confusing, so the easiest way to think about Part C is as health insurance plans provided by private insurers. Medicare Advantage bundles all Medicare health benefits (with or without drug coverage), plus extra services like vision, hearing, dental, and more.

Bottom line: If you or your loved ones use Medicare Advantage, you need to read this article — and take action before December 7. Also, if you have Original Medicare (with or without Supplemental or Medigap coverage) and want to switch to Medicare Advantage, now is the time.

What Medicare Advantage changes can you make right now?

There are three types of changes you can make related to Medicare Advantage.

1. Anyone with Original Medicare (Parts A and B, plus D for drug coverage) can switch to Medicare Advantage (Part C).
2. Anyone with Medicare Advantage can switch to Original Medicare. (Keep in mind that Supplemental or Medigap coverage is outside the scope of this article.)
3. Anyone with Medicare Advantage can switch to another plan within Medicare Advantage.

It’s not important that you remember all three scenarios, but it is critical that you know which scenario applies to you.

Should you consider switching?

There are several reasons to consider changing Medicare plans.

The most obvious one is if you are unhappy with your current plan, whether Medicare Advantage or Original Medicare. Perhaps your real out-of-pocket costs are much higher than you expected, or maybe you are not happy with the service you are getting (or availability of specialists you need).

Other reasons might be less in-your-face but just as important. For example, you may be moving (or buying a second home out of state) and need coverage that will meet you wherever you are. Also, a change in your health might signal a need for new medications, specialty doctors, or certain facilities that may not be easy to access under your current plan.

3 steps to choose the best Medicare plan for you

There are three things to consider before you can select the best Medicare plan for your needs in 2020.

First, what doctors and hospitals are in-network? If you want to keep the medical team that’s already familiar with your history, you need to make sure they will be covered under your new plan. Don’t expect that everything will stay the same from year to year. Provider networks change, and not all providers accept Medicare Advantage. If you are switching to get to a certain specialist, make sure the plan you are considering will be accepted.

Second, what are your prescription medication needs? Prescription drug coverage is tricky to sort out. If you have a lengthy list of prescriptions, you must look at what’s covered by the plan you are considering. The good news is that the Medicare plan comparison tool on www.Medicare.gov will help you do that. Make a list and be prepared to type in the name, dosage, quantity, and frequency for each drug that you take regularly. Pay attention to the distinction between brand name and generic medication, especially if you know you need one or the other.

Finally, consider your maximum out-of-pocket costs for the year. Yes, some Medicare Advantage plans have premiums that are significantly lower than Original Medicare, but premium alone doesn’t tell the whole story. Look into deductibles and co-pays for everything from prescription refills to specialist visits to hospital stays. Back-of-the-napkin math is better than no math at all!

Of course, nobody has the crystal ball to predict 2020 with perfect clarity. I recommend that you make your best guess — and do the math on the worst-case scenario (catastrophic illness or accident). That way, you and your family will have a better of chance of being financially prepared.

So, what are the big take-aways?

Remember that the Annual Enrollment Period for Medicare ends on December 7. Take some time now to think about your medical situation, review available plans, talk to your doctors, and do the math. There won’t be another opportunity to make a change until October 2020, unless you have a life change like job change or loss of spouse.