How to Switch Medicare Plans During Open Enrollment

Insurance Services Tips 

Are you considering switching your Medicare plan? Open enrollment is the time to do it. This period runs from October 15 to December 7, and it’s the only time of year when you can make changes to your Medicare coverage. Whether you’re looking to lower your costs, expand your benefits, or switch from Original Medicare to a Medicare Advantage plan, here’s what you need to know.

Assess Your Current Plan

Before you start exploring new plans, take a closer look at your current one. What are your premiums, deductibles, and copays? What services are covered, and what are the out-of-pocket costs? What are the network restrictions, if any? What medications are covered by the plan’s formulary, and what are the costs?

Make a list of the pros and cons of your current plan, and think about what you’d like to change. For example, if you’re paying high premiums for benefits you rarely use, you might want to switch to a plan with lower premiums and higher copays. Or if you’re taking a new medication that’s not covered by your plan, you might want to switch to a plan with a more comprehensive formulary.

Explore Your Options

Once you have a clear idea of what you’re looking for, it’s time to start shopping around. Medicare has a Plan Finder tool on its website that can help you compare plans based on your location, health status, and prescription drug needs. You can also contact a licensed insurance agent who specializes in Medicare to help you navigate the options.

When you’re comparing plans, pay attention to the following factors:

  • Premiums: This is the monthly amount you pay for your coverage.
  • Deductibles: This is the amount you pay out of pocket before your plan starts covering your costs.
  • Copays and coinsurance: These are the amounts you pay for each service or medication you receive.
  • Benefits: This includes services like dental, vision, and hearing, which may not be covered by Original Medicare.
  • Network: This refers to the providers and hospitals that are in your plan’s network. If you go out of network, you may have to pay higher costs.
  • Formulary: This is the list of medications that are covered by your plan.

Consider Your Health Needs

When you’re choosing a new plan, it’s important to consider your current and future health needs. If you have a chronic condition or take expensive medications, you’ll want to choose a plan that covers those services at a lower cost. If you’re in good health and don’t anticipate needing many medical services, you may be able to choose a plan with lower premiums and higher copays.

It's important to note that Medicare Advantage plans often have lower out-of-pocket costs for people with chronic conditions who require frequent doctor visits or expensive medications. These plans may also offer additional benefits like transportation to medical appointments, meal delivery, and fitness programs that can help you manage your health.

Don’t Forget About Medicare Advantage

If you’re currently enrolled in Original Medicare, you may want to consider switching to a Medicare Advantage plan. These plans are offered by private insurance companies and provide the same benefits as Original Medicare, plus additional benefits like dental, vision, and hearing. They also have out-of-pocket maximums, which can help you limit your costs.

When you’re choosing a Medicare Advantage plan, make sure to consider the following:

  • Network: Medicare Advantage plans usually have a network of providers and hospitals that you must use in order to receive coverage.
  • Benefits: Medicare Advantage plans often offer additional benefits like dental, vision, and hearing, but they may also have higher copays and deductibles.
  • Formulary: Medicare Advantage plans have their own formularies, so make sure to check that your medications are covered.
  • Costs: Medicare Advantage plans may have lower premiums than Original Medicare, but they may also have higher out-of-pocket costs.

It's important to note that not all Medicare Advantage plans are created equal. Some plans may have lower premiums but higher out-of-pocket costs, while others may have higher premiums but more comprehensive benefits. It's important to compare plans carefully and choose one that meets your specific needs.

Enroll in Your New Plan

Once you’ve chosen a new plan, it’s time to enroll. You can do this online, by mail, or by phone. Make sure to enroll before December 7 to ensure that your coverage starts on January 1.

Before you enroll, make sure to review the plan’s details and confirm that it covers the services you need. You should also check that your doctors and hospitals are in the plan’s network.

Final Thoughts

Switching Medicare plans can be a daunting task, but it’s worth it if you can save money or get better coverage. Take the time to assess your current plan, explore your options, and consider your health needs. And don’t forget to enroll before December 7 to ensure that your coverage starts on January 1.

It's important to note that Medicare open enrollment is also a good time to review your prescription drug coverage. If you're enrolled in a Medicare Part D plan, you can switch to a different plan during open enrollment if you find one that better meets your needs.

Remember, you have the power to choose the Medicare plan that works best for you. Don't be afraid to shop around and ask questions. With a little research and careful consideration, you can find a plan that meets your needs and fits your budget.