Most people need more healthcare as they grow older, and for the millions of Americans who qualify, Medicare coverage is an essential part of making sure that they can afford to meet their healthcare needs. But in order to make the most of your Medicare coverage, you need to understand all the options that the program gives you and make the best choices for you in your individual situation.
The time to make those choices is now, as we're currently in the annual Medicare open enrollment period. From Oct. 15 to Dec. 7, Medicare participants have a number of things to consider, as changes are available that in some cases can better tailor your coverage to your particular health issues. With just six weeks left until the close of Medicare open enrollment this year, you can't afford to waste time in looking at how to take better advantage of your coverage options.
Why Medicare has open enrollment
Medicare open enrollment gives participants in the program the same ability to make changes to their healthcare coverage that most private insurance companies give their policyholders. Because Medicare offers people choices with respect to their healthcare, open enrollment gives you an opportunity to review whether your current plan is meeting your needs or whether a change could lead to better outcomes.
Several alternatives are available. For those who have coverage currently under traditional Medicare, you can elect to switch to a Medicare Advantage plan beginning in 2019. Conversely, if you have a Medicare Advantage plan already, you can switch back to traditional Medicare.
Moreover, several switches across various privately offered plan options are available. If you have Medicare Advantage plan coverage now but would prefer a different plan, either from the same provider or from a different health insurance company, then making the shift is possible during open enrollment. Prescription drug coverage under Medicare Part D also offers a chance to switch plans, either by choosing separate drug plans or by selecting an option that's incorporated into a Medicare Advantage plan.
How to make smart changes to your Medicare coverage
The biggest challenge facing Medicare participants is how best to cover their total healthcare costs. It's easy to fall into the trap of just looking at whatever plan offers the lowest monthly premiums. Traditional Medicare charges premiums for Part B medical coverage, and many Part D prescription drug plans also have monthly premium costs. However, some Medicare Advantage plans highlight their lower monthly premium costs as a key benefit.
However, the smarter way to think about Medicare choices is to consider all of your costs. For instance, if a plan with a cheaper premium doesn't cover prescription drugs that you already know you'll need, then you could end up paying far more out-of-pocket to buy those drugs than if you enrolled in a more comprehensive healthcare plan. Even if that plan had higher monthly premiums, the savings from having drug coverage included could more than make up for the premium costs.
To get a complete picture, you have to look beyond premiums to consider deductible amounts that a plan charges before coverage kicks in, the amount of co-payments on items like doctor visits, and percentage-based coinsurance amounts for certain medical services. On top of that, you also have to make a reasonable prediction of whether your healthcare needs will change over the next 12 months, as in all likelihood, you won't be able to make further changes until this time next year.
It's true that the annual open enrollment period that's going on now isn't necessarily your only chance to make coverage changes. An initial enrollment period opens up when you first give up your employer-sponsored health coverage, and special enrollment periods are available if you move to an area that your current plan doesn't cover or if changes to your outside healthcare coverage options occur.
However, annual open enrollment gives you the most flexibility to consider all of your Medicare options at once. Procrastinating can be dangerous, so be sure to take action now so that you don't end up wasting the next six weeks and having nothing to show for it.