Are you ready for open enrollment?

by Bill Decker
American Legacy Solutions

As open enrollment approaches for Medicare recipients, here are a few ideas that may help you get the most from the options available to you this year.

As you know if you have been dealing with Medicare for any amount of time you are familiar with how Medicare has updates and even changes from year to year. Those changes can range from your premium for part B going up to the deductible for part A, B or D changing. So, let’s see if we can make this a bit easier for you this year.

As you probably already know the two ways to most people work with Medicare is to customize their coverage with supplement Plan (F, G, N or similar and a PDP plan for prescriptions). During this open enrollment period, you just need to check your prescriptions and your plans formulary to see if there are any changes for the upcoming year. What you are looking for is to see if your prescriptions are in the same tier as this year and if your co pays have gone up. It you don’t like your results you can shop your part D plan to find one that fits your needs better. Medicare.gov can be a big help with that or call your local independent insurance representative to help you find the best choice for your needs.

Now if you have chosen the Part C or the Advantage way of working Medicare you might have some more work to do however the extra effort that you put in could pay you dividends for the upcoming year.

Step 1 Make sure your favorite Doctors are staying in your plan. As the health care industry continues to evolve physicians are being forced to make hard decisions about the plans they accept. Have you ever had a doctor stop taking a certain plan? Usually they will let you know, however just to be on the safe side just confirm that you are good for the upcoming year.

Step 2 The prescription check, Over the last several years there seems to be more and more changes in this part of plans, confirm your formulary with next year’s plan and if you are a person that deals with the Donut hole (you know who you are) confirm what type of coverage you will have during that period so you can get an idea of what your cost are going to be.

Step 3 Since most advantage plans are managed care plans, companies are also trying to sweeten the deal to get you to come with them. This is where you might find the extra goodies like dental coverage, vision coverage, hearing aids, over the counter discounts and even gym memberships and transportation to doctor visits. Ask yourself what is important before you get to excited with all those freebies or extras because sometimes they tend to come at a cost. Please make sure to check the Star rating of a plan when you see all the extras. Star Ratings are updated every year and tend to show the satisfaction from other members to the specific plan. Lower star rating can mean lower reimbursement form Medicare and make approvals for service and referrals more difficult. Higher star ratings do tend to show overall member satisfaction in plans and now better reimbursement. Really what that means for you is referrals and services tend to be handled faster. if plans have higher star ratings and are offering some extra benefits you might have found something special.

So, to summarize and keep this simple check your Doctor is staying with your plan, confirm your prescription cost, see if there may be extra services from plans that meet step 1 and 2 to your satisfaction. Good luck

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