Making your annual Medicare plan review work for you

Choosing a Medicare plan can feel overwhelming, but the good news is you get a chance to revisit your choices every year. From October 15 to December 7, you have the opportunity to review your current Medicare Advantage and Part D (prescription drug) plans and make changes for the coming year. This annual review is not just a formality; it's a practical step that can ensure your coverage aligns with your current health and financial situation.

Why review every year?

Your health needs can change. Medications you take might be added, changed, or discontinued. Your doctors might join or leave a plan's network. And importantly, plans themselves change their offerings, costs, and formularies (the list of covered drugs) every single year. The plan that was perfect for you last year might not be the best fit next year, even if your own health status remains constant. Taking the time to look over your options can prevent unexpected out-of-pocket costs and ensure you have access to the care you need.

Think of it like balancing your checkbook or doing a routine car maintenance check. It's a small investment of time that can yield significant benefits.

What to look for during your review

When you sit down to compare plans, focus on a few key areas:

• Your prescriptions: Check if all your current medications are covered by the plan's formulary for the next year, and what tier they fall into. Also, look at the costs at your preferred pharmacy. Don't assume. Formularies change.
• Your doctors and specialists: Confirm that your preferred healthcare providers are still in the plan's network for the upcoming year. If you have a Medicare Advantage plan (Part C), this is especially important. Original Medicare generally allows you to see any doctor who accepts Medicare.
• Your total costs: Beyond the monthly premium, consider the deductible, co-pays, co-insurance, and the plan's out-of-pocket maximum. These figures can vary widely and significantly impact your annual healthcare expenses.
• Benefits and extras: Medicare Advantage plans often include additional benefits like dental, vision, hearing, or fitness programs. See if these extras are still valuable to you and compare them across plans.
• Star ratings: Medicare uses a 5-star rating system to evaluate plans based on quality and performance. While not the only factor, it can be a helpful guide when comparing similar options.

Tools and resources to help

The official Medicare website, Medicare.gov, is your primary resource for comparing plans. Its Plan Finder tool allows you to enter your medications and preferred pharmacies and then displays plans available in your area, along with estimated annual costs tailored to your specific drug needs. It's a robust tool designed to empower you to make informed decisions.

In addition to the online tool, you can call 1-800-MEDICARE (1-800-633-4227) for assistance. State Health Insurance Assistance Programs (SHIPs) also offer free, unbiased counseling to Medicare beneficiaries. These programs can be particularly helpful if you find the process confusing or prefer to speak with someone directly. They are not affiliated with insurance companies and provide impartial advice.

A habit that pays off

Making your annual Medicare plan review a yearly habit is one of the most proactive steps you can take to manage your healthcare costs and access. It doesn't require deep medical knowledge or financial expertise, just a willingness to invest a small amount of time to protect your health and your wallet. By consistently checking your options, you ensure your Medicare coverage remains a strong and supportive part of your overall health strategy, adapting as your life and the healthcare landscape evolve.