How to pick the right Medicare Advantage Plan for you
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This article is brought to you by Select Health, a nonprofit health plan serving Utah, Idaho, Nevada and Colorado, with over 1 million members nationwide. Committed to the well-being of its members and communities, Select Health shares a mission with Intermountain Health: helping people live their healthiest lives possible.
Selecting the right health plan is a personal decision, and with Medicare, there’s no one-size-fits all solution. The Medicare Annual Enrollment Period (AEP) offers a yearly opportunity to review and adjust your coverage to fit your current healthcare needs. Whether you’re enrolling for the first time or comparing existing plans, having the right information simplifies the decision-making process.
Medicare annual enrollment period: Oct. 15 – Dec. 7
From Oct. 15 through Dec. 7, the Medicare Annual Enrollment Period allows beneficiaries to review and change their coverage. It’s essential to review your coverage each year to ensure it meets your needs. Once you have compared plan options and costs, speaking with a licensed agent or an insurance company representative can provide additional clarity. Make sure to act promptly so you don’t miss the enrollment deadline.
“As AEP begins, it’s an opportunity to fine-tune your healthcare coverage and ensure your plan fits your needs,” said Trent Nate, Vice President of Select Health Idaho.
Understanding Medicare
Medicare is a federal program that provides health coverage for individuals 65 and older or those under 65 with certain disabilities or End-Stage Renal Disease (ESRD). Eligibility requires that you or your spouse have worked for at least 10 years, and that you are a U.S. citizen or permanent resident. Medicare is divided into four parts:
- Part A covers hospital services.
- Part B covers medical services and requires a monthly premium.
- Part C (Medicare Advantage) bundles hospital, medical, and often prescription drug coverage into one plan, sometimes requiring an additional premium.
- Part D offers prescription drug coverage only.
Medicare Advantage plans bundle hospital, medical, prescription, and additional benefits like vision, dental, and hearing, while capping out-of-pocket costs and offering predictable copays.
Getting ready for AEP: Use a checklist
Being prepared is key to making an informed decision during AEP. A checklist can help you stay organized and ensure you have all the necessary information at hand. Consider the following:
- A list of your doctors, clinics, and hospitals.
- A list of your current prescriptions.
- A comparison of costs, such as monthly premiums, copays, deductibles, and out-of-pocket maximums.
- Any additional benefits you may need, such as dental, vision, or hearing coverage.
“When you use a checklist, it ensures you don’t miss any important details,” Nate said. “By organizing your doctors, prescriptions, and coverage needs in advance, you can make more informed choices that fit both your health and budget.”
Key questions to ask about Medicare Advantage plans
Finding the right Medicare Advantage plan can be overwhelming. Asking the right questions can help you select a plan that suits your needs:
- What is the monthly premium? This is the amount you pay each month. Costs vary, so it’s critical to know how much you’ll pay before selecting a plan. Some Select Health Medicare plans offer – premiums as low as $0.
- Are my prescription drugs covered? Check the drug formulary for coverage, costs, and restrictions, including quantity limits, prior authorization, and pharmacy access.
- Are my preferred doctors and hospitals included? Ensure your plan covers your regular providers and facilities. Out-of-network care could result in higher costs. In Eastern Idaho, Select Health Medicare partners with providers from Eastern Idaho Regional Medical Center, Mountain View Hospital, and Idaho Falls Community Hospital.
“Choosing the right Medicare Advantage plan starts with asking the right questions,” Nate said. “Understanding costs, checking prescription drug coverage, and confirming your doctors and hospitals are in-network boost confidence in your choice.”
Additional perks of Medicare Advantage plans
Some Medicare Advantage plans offer added value through extra benefits like gym memberships, grocery and over-the-counter allowances, or wellness programs. For example, Select Health Medicare offers:
- Papa Pals: Assistance with household tasks, technology, transportation, and companionship.
- Monthly grocery benefit: Eligible members can receive up to $55 per month for groceries at Smith’s or Fred Meyer through a Select Health Medicare + Kroger plan.
- Care and disease management: Care managers coordinate services between members and physicians and help members understand their diagnoses and treatment plans.
- Member advocates: Help with finding doctors, scheduling appointments, and addressing specific needs, such as language assistance.
- Intermountain Connect Care: Access to a healthcare provider via smartphone or computer for minor health concerns like fevers or joint pain.
“Selecting a Medicare Advantage plan with extra perks like gym memberships, grocery benefits, and telehealth services adds significant value,” Nate said. “These benefits not only enhance the overall care experience but also contribute to a healthier lifestyle.”
Expert help and resources
Navigating Medicare can be complex, but help is available. Local agents can guide you, even discussing your options with family can provide valuable insights. Take advantage of these resources to ensure you’re choosing a Medicare plan that best supports your health needs. For personalized assistance, visit selecthealth.org/medicare or call (855) 442-9940.