Choosing the right Medicare Advantage plan is not only important, it's personal.
This week is the start of the Medicare Annual Enrollment Period. It runs from October 15 through December 7 every year. and is a great opportunity to review your coverage or switch plans.
If you are enrolling for the first time or evaluating different Medicare plans, you may be searching for answers or additional resources to inform your decision.
Matt Shulsen with Select Health joined us information and helpful tips.
He explained that original Medicare may leave you responsible for 20 percent of your costs without any limit, whereas a Medicare Advantage typically has an out-of-pocket maximum to protect you financially.
He explained that Medicare Advantage is all-in-one coverage that includes hospital and basic medical coverage.
In addition, it may also include numerous extra benefits like vision coverage, dental coverage, and hearing aid coverage.
Matt says during Open Enrollment you should take the time to educate yourself and review your plan options specific to you. Review any changes in your life or health. Seek input from family members or give Select Health a call for help. What may have been a great plan last year may not suit your needs anymore.
Some plans also have additional incentives for making healthy choices and demonstrating healthy behaviors. Check to see if your plan has a wellness benefit such as coverage for gym memberships or other healthy activities.
Look at the plan's Star Rating - Medicare uses ratings 1 -5 to help you compare plans. The 5-Star Quality Rating can tell you a lot about a company's customer service, member satisfaction, benefits, and overall quality. For the third straight year, Select Health Medicare HMO Plans received the top rating, 5 out of 5 Stars.
If you are looking for a Medicare Advantage plan this year here are some good questions to ask::
o How much will my monthly premium be? Many Select Health plans have $0 premium.
o Are my prescription drugs covered? Plans vary in how they cover prescription drug coverage. You want to ensure that you are evaluating plan options with your specific prescription drugs in mind.
o What are some bonus perks available with Medicare Advantage plans? Select Health has a Medicare Advantage plan the provides a monthly grocery benefit for some members. With Select Health's new partnership with Kroger, those with qualify conditions such as diabetes for example, can receive up to $55 monthly and up to $660 a year to use at Smith's grocery store.
o Does my plan have a health and wellness incentive or gym reimbursement? Select Health offers Wellness Your Way Benefits – which encourages members to stay active and maintain their physical and emotional health. In Utah, some plans offer up to $360 a year to use for gym memberships, fishing licenses, admissions to national parks and more!
o What are my vision and dental options? What about hearing aids? All Select Health Medicare plans come with preventive and comprehensive dental coverage with no waiting periods! Coverage includes cleanings, fluoride, fillings, crowns, root canals, extractions, dentures, and more up to the plan's annual maximum with network providers. Some plans include both eyewear and hearing aid allowances.
Another important thing to consider when choosing a plan is prescription drug coverage.
Matt says Original Medicare and Medicare Supplement plans require beneficiaries to enroll in a stand-alone prescription plan from a private insurance company.
A Medicare Advantage plan, depending on the one you select will include Prescription Drug Coverage at no added cost.
If you are thinking about staying with your current plan, you should check your Evidence of Coverage and Annual Notices of Changes document to see if there have been any changes to your medication coverage.
• When reviewing a drug formulary, make sure to check:
o Drug brand names and generics.
o Quantity limits (how much you can get in a specific time-period).
o Prior authorization requirements.
o Limited pharmacy access (some drugs are only available at specific pharmacies).
o Prescription tiers and the associated costs.
Matt also says for those enrolling in Medicare for the first time, you have a seven-month window around your birthday month to enroll. That is: Three months before your birthday month, three months after your birthday month, and of course, during your birthday month.
If you have questions, you can contact the Select Health Medicare Team at 855-442-9940 or visit selecthealthmedicare.org
You can also work with a licensed, certified local insurance agent to walk through your options. This is a great option if you have questions or
