Medicare Open Enrollment: Do you Have the Right Plan?

Medicare open enrollment is often overlooked by financial advisors who are scheduling meetings in the final quarter. The low hanging fruit items of reviewing investment portfolios to identify tax-loss (and sometimes tax-gain) harvesting opportunities, roth conversions, and maximizing contributions to retirement plans generally take priority. Medicare Open Enrollment begins October 15th and runs through December 7th for coverage beginning January 1st. Open Enrollment is also a good time to ask yourself whether you’re truly satisfied with your medical care.

Choosing a plan is an important and personal decision (and not a one-time decision). The lowest-cost health plan option might not be the best choice for you. Which is why financial advisors should encourage clients to look beyond changes to monthly premiums but scrutinize other out-of-pocket costs, such as increased deductibles or a plan switching to a more expensive coinsurance cost sharing method. Your time is valuable so you want your plan providers and rules to be convenient for you. Where are the doctors’ offices? What are their hours? Which pharmacies can you use? Can you get prescriptions by mail? Do the doctors use electronic health records or prescribe electronically?

About a third of Medicare beneficiaries forgo the original Medicare route and opt instead for a private Medicare Advantage plan (also known as Medicare Part C), which provide additional benefits that original Medicare doesn’t cover, such as dental services, hearing, and vision, and some might even provide a free gym membership. This Medicare Part C plans on less expensive than original Medicare but, however, restrict access to in-network healthcare providers.

The key chooses to make during open enrollment is for clients to move from original Medicare to Medicare Advantage, switch from one Medicare Advantage plan to another, or choose a different Medicare prescription drug plan (Medicare Part D). Medicare Advantage members can decide to return to orginal Medicare during open enrollment, but when they apply for a private Medicare policy, they will be subject to medical underwriting that did not exist during their initial enrollment period (three months before the month they turn 65 and extended three months after). If you need help on what to decide you can take the 10 question quiz at https://www.medicare.gov/medicarecoverageoptions/.

Not all health care is created equal, and the doctors, hospitals and facilities you choose can affect your health. Remember that even if you’re happy with your current plan, these answers might change from year to year—so it’s important to take the time to compare.
The Medicare Plan Finder (https://www.medicare.gov/find-a-plan/questions/home.aspx) makes it easy to compare plans based on all of these factors, so you can choose a plan that meets your needs.On the website there is a four video guide to assist you on how to look for plans with a 5‑star performance rating—the right expertise and care can make a difference.

For additional assistance, The National Council on Aging offers a free online guide to Medicare Open Enrollment. An online questionnaire helps Medicare beneficiaries compare plans and get free, detailed information from licensed benefits advisors. Those who live in California, I would recommend using The HICAP network (http://www.aging.ca.gov/HICAP/) who provides free, confidential counseling and community education for California Medicare beneficiaries, their representatives, and people who will soon be eligible for Medicare. Assistance is available related to all aspects of Medicare.

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