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4 Signs You Need a New Medicare Advantage Plan

By Maurie Backman – Oct 25, 2021 at 5:36AM

Key Points

  • Medicare Advantage enrollees can choose between different plans.
  • Between now and Dec. 7, you can change your coverage for 2022 during Medicare's open enrollment.
  • You may want to consider a new Advantage plan if your current plan has its share of shortcomings.

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If these factors apply to you, it may be time to make a switch.

Medicare's fall open enrollment is now in full swing through early December. If you're a current beneficiary, you have a chance to make changes to your coverage for the coming year.

Many seniors opt for Medicare Advantage plans as an alternative to original Medicare. If that's the route you've taken, you may not want to keep your current plan for 2022. In fact, here are a few signs that a change may be in order.

Person at laptop

Image source: Getty Images.

1. Your premiums are high

When you sign up for original Medicare, there's a standard Part B premium that applies to all enrollees except for high earners, who are subject to a surcharge. But the premium you pay for Medicare Advantage will hinge on the specific plan you select. And if you're paying a lot right now, it could pay to make a switch.

The Centers for Medicare & Medicaid Services estimates that the average Medicare Advantage premium in 2022 will be $19 per month. That's actually a drop from $21.22 a month in 2021. If you're paying a lot more than that, you may want to consider getting a new plan.

2. Your healthcare needs have changed

Any time your healthcare needs change, it's a good idea to assess your coverage and make sure it's working for you. The great thing about Medicare Advantage is that many plans offer supplemental benefits that could help cater to a host of medical conditions. And if your current plan doesn't offer the ones you want or need, then it's smart to look at other options.

Say you're diagnosed with diabetes. Based on that, you may be eligible for certain benefits under a new Advantage plan, like meal delivery. In that case, a switch would make sense.

3. It's been a struggle to find in-network providers

When you sign up for a Medicare Advantage plan, you're limited to a specific network of providers. Going out of network could leave you liable for hefty costs you can't easily cover.

If you've been having a hard time accessing doctors or pharmacies within your network, then it may be time to switch to a new Advantage plan. A different plan might give you more choices, or choices that are more convenient.

4. You're being charged a fortune for your medications

The cost of your medications will hinge on the coverage your Advantage plan offers. If you're paying a lot of money for the prescriptions you take, see if another Advantage plan will charge less for them.

Time to make a move?

There are plenty of good reasons to enroll in a Medicare Advantage plan over original Medicare. But if these things apply to you, it could be time to swap your current Advantage plan for a new one.

Any changes you make during fall open enrollment will take effect at the start of 2022. But here's some good news -- if you select an Advantage plan you end up not liking, you'll have an opportunity to drop it and find a different one between January 1 and March 31. You can even sign up for original Medicare during that window if you get fed up with Medicare Advantage altogether.

Still, it pays to do plenty of research over the next number of weeks. A little effort on your part could make your healthcare costs far more manageable in the coming year.

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