Give Your Plan a Checkup

Medicare and Medicare Advantage Plans can undergo significant changes each year. This includes alterations to co-pays, prescription drug coverage, and overall benefits, with some services being added, reduced, or even eliminated. Taking time to review your plan each year can help avoid unpleasant surprises and capture new benefits.

 

The Importance of an Annual Review

A study by the Kaiser Family Foundation revealed that nearly half of Medicare enrollees rarely or never review their plans, sticking with the same plan year after year. About 60% of those 85 and older also skip reviewing their plans annually. This oversight can lead to missed opportunities for savings and better coverage.

Among the most common changes is provider networks, which include hospitals, pharmacies, doctors, and other healthcare providers. Check in annually to ensure your preferred doctors and hospitals remain within your plan’s network. If not, you may face higher costs or have to find new providers to preserve full coverage.

 

Prescription Drug Coverage

Frequent changes to drug coverage are also common. Medicare and Medicare Advantage drug plans can modify their formularies every year. Formularies are the covered drugs and their associated costs. A new plan might offer a more favorable formulary or tier structure for your medications, potentially reducing out-of-pocket expenses.

Pharmacies accepted by your plan can also change. If your preferred pharmacy is no longer in network, you may need to switch or face higher costs for prescriptions.

 

Key Factors in Your Annual Review

Many people report satisfaction with their Medicare coverage. Reviewing the following factors can ensure you will, too.

1   Changes in Your Health. Health needs can change, requiring more frequent visits to doctors, different medications, or new healthcare services. Make sure your

plan meets these changing needs.

2   Availability of New Plans. Medicare benefits vary by plan, and new options may become available in your area that better meet your needs. Check each year for new offerings. New plans also may offer reduced out-of-pocket costs.

 

Help is There — No Charge

While reviewing your plan annually may seem as daunting as preparing taxes, it needn’t be, and the benefits can be significant. Expert assistance is available at no cost in most communities to help navigate changes in your needs and available coverage. Find help near you in these pages.