Things to consider during Medicare open enrollment
Those who are covered by Medicare know it’s that time of year — annual enrollment period, your once-a-year chance to change your health care coverage or validate you’re happy with your current coverage. You only have until Dec.7 to make changes.
So what should you consider during this open window? Here are the big ones:
Are you happy with your current doctors? If you are, great. No? Time to do a little research. Consider what’s important to you. Should the doctor’s office be near your home? Is the staff friendly? Do they have extended hours? Is it easy to get an appointment? Do they focus on preventive care?
For 89-year-old Olga Alvarez, a warm and caring staff is key. “When you’ve lost all of your family, you can get lonely,” Alvarez said. “But the Optum — Westchester clinic has blessed me. I have the most beautiful medical staff I could ever dream of. They are like family to me.”
Alvarez is blessed with good health, and she credits the exceptional physical and emotional care she has received from her care team for more than 23 years. Regular visits and preventive testing have helped her stay on top of her good health.
“I have been so lucky with my primary care physician. After the first visit, I simply loved the kind of person she is as she gave me peace and ease of mind,” she said.
If you find a new doctor, do they accept your current health plan? Be sure to check with any potential new doctors to ensure they take your health plan. If not, you will need to choose a different doctor or change your health plan.
Does your current health plan work for you? Does your plan fit your budget? Does it offer the benefits you need and want? If not, do some comparison shopping or enlist a licensed insurance agent to do the lifting for you. Rely on their knowledge to help you make the right decision.
Has your plan made changes? Before you let the enrollment period pass you by, be sure you know if your plan has changed and if those changes work for you. Perhaps the costs of your prescriptions have changed. Maybe your primary care doctor or your specialist switched to a different network. Or maybe your current plan won’t adequately cover your anticipated medical needs and expenses for the upcoming year. Be sure you are well-informed about any changes in your current plan.
Can a Medicare Advantage Plan work for you? A Medicare Advantage Plan is a plan in which a private insurer is paid by Medicare to manage your health care costs. With a Medicare Advantage plan, you:
Work within a network of doctors and hospitals
Receive Part A, Part B and often Part D prescription drug coverage
Will not have an upfront additional premium; you only incur cost if you receive care
Have an out-of-pocket maximum
May be able to receive a Medicare premium reduction
Can Medicare cost you less than the standard premium? Yes, there are many Medicare Advantage Plans that now offer a reduction in your Medicare Part B premium as part of the benefits they provide. It is possible for Medicare to cost you less than the standard rate of $164.90 per month – often between $70 and $148 less per month. For full information, visit www.medicare.gov or call 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day, 7 days a week.
Your Medicare choices should make you feel confident you have the right doctors and the right plan to suit your personal situation and needs. With a little bit of work and knowledge, you may end up as pleased as Olga Alvarez.
“Optum — Westchester has been blessed with a medical team of the highest quality, as all of the providers are excellent,” Alvarez said.
“I just want everybody to know that your doctor’s office should work just right for you. For me, everything works the right way. That’s why I love it.”
