1. UNDERSTAND WHAT YOU HAVE: You need to read the Annual Notice of Change from your current insurers?
  2. How much discretionary income do you have each month? If it’s low, it might limit your choices or help you qualify for assistance.
  3. What is the total cost of the plans you’re considering? Don’t just look at the premiums.  Try to estimate what you’ll spend in co-pays.  Compare deductibles.  If you know you need an expensive procedure, such as a knee replacement, include that in your cost estimate.
  4. How important is it to keep your current doctors? If that matters to you, make sure they are included in a Medicare Advantage plan’s network.
  5. How is your plan going to cover a serious illness? If you want access to research hospitals, check to see if NCI cancer centers are in the network. You may also be interested in where you could get neurological, heart or orthopedic care.  Make sure you know how much it costs to go out of network for specialists.  Long suggests that you check out how the plan covers outpatient surgery, hospital stays, durable medical equipment, chemotherapy, and skilled nursing stays.
  6. Are the drugs you take covered? Compare co-pays and note whether any plans require prior authorization. Pay special attention to the “tiers” under which your drugs are covered.
  7. Have you looked at the star ratings for Advantage and drug plans you are considering? The government gives plans up to five stars on quality measures. Some of what it considers may not be important to you, but Hoadley suggests digging deeply into the ratings to learn about complaints, customer service and drug pricing.  “If I suddenly see a cheaper plan that’s only got two stars, that’s a red flag for me,” he said.
  8. Do you spend a lot of time in other parts of the country? If so, you’ll need to know how plans with narrow, local networks would handle your getting sick somewhere else.
  9. What does your doctor think? Ask your doctor whether he or she has had experience with the plan you are considering. Does your doctor intend to stick with it for the foreseeable future.
  10. Will using this plan be convenient? Check which pharmacies you can use and whether there’s a mail-order option.  See how far you’d have to go for a network hospital and where you’d be sent for imaging and blood tests.

Medicare Annual Election Period is different from the Marketplace Open Enrollment

Medicare Annual Election Period is different from the Marketplace Open Enrollment

Medicare Advantage SAvings could cost you your doctor and healthcare network.