Enrolled in an Advantage plan? You have a limited opportunity to
find a better one.
Maurie Backman (TMFBookNerd) Jan 12, 2020 at 7:49AM
Seniors on Medicare are generally familiar with its
annual open enrollment period, which runs from Oct. 15 through Dec. 7. But if
you're enrolled in Medicare Advantage, there's a new set of dates
you should commit to memory: Jan. 1 through Mar 31. That's because Medicare
Advantage now has its own open enrollment window, and if you have an Advantage
plan, it could really pay to capitalize on it.
What can you do during
Medicare Advantage's open enrollment?
If you're enrolled in original Medicare, then
there's no action for you to take during Medicare Advantage's open enrollment.
On the other hand, if you have an Advantage plan, you can do two key things:
·
Swap your existing Advantage plan for a new one.
·
Drop your Advantage plan and sign up for original Medicare (including
a Part D drug plan).
When does it pay to
switch Advantage plans?
Many Medicare Advantage plans cost less than
original Medicare when you factor in the cost of Part D for prescription
coverage, plus supplemental insurance. And, you'll often get a wider scope of
coverage with Advantage.
Original Medicare, for example, will not pay
for dental care, vision exams, and hearing aids,
whereas Medicare Advantage often does. Some Advantage plans also offer a number
of wellness benefits that include coverage for gym memberships. And, if you
have a condition that warrants it, you may even be entitled to added benefits
like meal delivery to your home or special fixtures or accommodations for your
living space, like carpet cleanings to eliminate asthma-inducing dust or guard
rails for your shower or tub.
But there's a downside to Medicare Advantage,
and it's that under it, you're limited to a specific, and often narrow, network
of healthcare professionals and pharmacies.
Generally, these providers are condensed to the geographic area you're based
in, which is good if you're a homebody, but not great if you split your time
between two different states during the year or want the flexibility to travel
the country. Plus, providers can switch networks at any time, so if you do manage
to find a doctor you trust, there's no guarantee he or she will be accessible
to you for the long haul based on your plan.
And these are just some of the reasons it pays
to shop around for a new Advantage plan during winter's open enrollment. If the
providers you're limited to aren't conveniently located, or you have a specific
doctor you're looking to keep, then it pays to see if switching plans gives you
what you want.
There's cost to consider, too. You may be
entitled to certain benefits under Medicare Advantage, and your premiums might
cost less than what you'd pay for original Medicare, Parts B and D and Medigap
included. But if you're constantly going out of network because of your
Advantage plan's restrictions, then switching plans or even getting on original
Medicare could be cheaper.
Finally, remember that coverage under the same
Advantage plan can change from one year to the next. It could be that the
prescriptions you take are no longer covered under your plan, or cost you a lot
more. In that case, it certainly pays to think about switching.
Though the idea of finding a new Advantage plan
may seem daunting, Medicare.gov has a new plan finder tool that makes comparing your options
much easier. Spend a little time seeing what's out there if you have an
Advantage plan you aren't completely satisfied with. And even if you do like
your plan, it wouldn't hurt to see there's a lower-cost alternative that offers
comparable coverage.
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