Are you considering changing Medicare Advantage plans? (Medicare Part C)? You’re likely looking for lower prescription costs, smaller premiums, and more doctors.
However, switching can present challenges. Licensed Medicare agents often see these seven common mistakes.
Common Problems with the Wrong Plan
Sticking with a poor plan can lead to issues like:
- Long waits with unhelpful customer service
- Overpaying for prescriptions by $500-$1,000 annually
- Doctors not accepting your plan
- Higher overall costs
Understanding these problems can make you more comfortable changing Medicare Advantage plans.
Mistake #1: Not Knowing the Difference Between HMO and PPO
Most choose between HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) plans.
- HMO: Lower cost, limited network of doctors. Out-of-network visits aren’t covered.
- PPO: Higher cost, out-of-network coverage, more doctor options.
Mistake #2: Poor Prescription Coverage
Medicare Advantage plans often include Part D for prescriptions, but prices vary widely. Compare plans based on your specific prescriptions annually to save money.
Note:
- Medicare Part D drug coverage can only be bought with Original Medicare NOT Medicare Advantage.
Mistake #3: Limited Number of Doctors
HMOs have “closed” networks. Check if your preferred doctors are in-network before enrolling. PPOs offer more flexibility with out-of-network doctors, though at a higher cost.
Mistake #4: Not Knowing Your Right to Switch
You can change plans during the Annual Enrollment Period (Oct 15 – Dec 7) without health questions. There’s also an Open Enrollment Period (Jan 1 – Mar 31) where you can:
- Switch to another Medicare Advantage plan (If you are currently enrolled in one).
- Drop your Medicare Advantage plan and return to Original Medicare (Part A and Part B).
Mistake #5: Using the Wrong Criteria
Your friends’ plan might not be right for you. Compare based on your prescriptions and doctors.
Mistake #6: Fear of Using Insurance
Your premium is unrelated to your health needs. Insurers are incentivized to keep you healthy, so use your insurance.
Mistake #7: Insufficient Travel Benefits
Travel can reveal gaps in coverage. PPOs generally offer better travel coverage than HMOs.
Summary
Joining or changing Medicare Advantage plans can be straightforward. Keep these tips in mind to choose the best plan for your needs.
