Spokane Journal of Business

Avoid misconceptions when choosing Medicare plan

Annual plan selection period open through Dec. 7

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The Medicare annual election period, which started Oct. 15 and runs through Dec. 7, is a time for people with Medicare to make important decisions about their health care—just ask the 17.7 million people who decided on a Medicare Advantage plan in 2016.

There are many factors to consider so that you get the Medicare plan that best meets your health and budget needs.

To navigate your health care options during this year’s annual enrollment period, it’s important to remember what not to do.

When research-ing Medicare plans, people often focus on premiums and medical provider networks, but might not realize there’s more to consider. Knowing the benefits offered by Medicare Advantage plans and Medicare prescription drug plans, both of which offer enhancements to original Medicare, will also be pivotal in your decision making.

While Medicare Advantage provides the same coverage as original Medicare, Advantage plans often also include predictable copayments, lower or no deductibles, Part D prescription drug coverage, out-of-pocket limits for financial protection, and low or even zero monthly plan premiums.

Some of these plans offer additional features designed to meet members’ needs, such as dental, hearing and vision coverage, a nurse advice line that’s available 24 hours a day, and fitness programs.

Here are five common hiccups Medicare beneficiaries might experience when considering their options in search of a Medicare Advantage plan that will help them achieve better health and well-being:

•Your monthly payment isn’t the only factor to consider. While it’s tempting to gravitate to a $0 or low-premium monthly plan, it’s easy to overlook extra costs that can be incurred down the road, such as for hospital stays and medical procedures. After you analyze your previous year’s plan and assess the most affordable option for the coming year, consider the total value of the Medicare plan you select, along with your health, medical, and budget needs for the coming year.

•Your drug coverage isn’t the same everywhere. Surprisingly, drug prices can vary depending on your location, pharmacy, and how much you’ve used your prescription benefits over the course of the year. Be diligent by making a list of your medications; researching drug formularies—the list of drugs a Medicare prescription plan covers; and considering mail-order as you evaluate your prescription drug plan options. Some plans might offer lower costs if certain pharmacies are used.

•Your plan isn’t just for medical visits or emergencies. If you are living with a chronic condition, you may want to look for plans offering personalized care in the forms of health coaching, education, and support by registered nurses and other health professionals. Many Advantage programs also offer benefits, such as fitness programs, to help members maintain active lifestyles. 

•You might not need the same plan as your spouse or partner. Health needs vary, and what works in your Advantage plan may not be the best option for your spouse. It’s important for the two of you to sit down and assess your different health needs, health care providers, and whether your doctors will be covered in your plan. 

•You’re not on your own in making this decision. Use resources, such as a licensed Medicare health insurance agent, Medicare.gov or Humana.com/Medicare, to help identify the best plan for you. Understanding the resources and tools at your disposal will allow you to take “advantage” of all the benefits Medicare plans have to offer in 2018.

Catherine Field is the Seattle-based president and intermountain region market leader for senior products for
Louisville, Ky.-based health insurance company Humana Inc.

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