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Outside the Box: It’s open enrollment and your Medicare coverage needs a checkup

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Have your healthcare needs and personal finances changed since 2019? The answer is probably yes, especially if you’re a Medicare beneficiary. 

As I reach my first anniversary leading eHealth Inc., a company that serves Medicare beneficiaries, and as a Medicare-age person myself, I’ve learned how important it is to reassess your coverage options each year. That’s why I was surprised to see in eHealth’s recent survey of more than 1,000 beneficiaries that 53% are still enrolled in the same Medicare coverage they had in 2019.

Medicare’s annual enrollment period is currently under way. Here’s how to make sure you’ve got the best Medicare plan for your evolving needs.

Read: Confused about Medicare open enrollment? How to maximize your coverage.

Review your needs

Start by reviewing how your medical history and personal finances may have changed. Our survey found that in the past year about half of Medicare beneficiaries started taking new prescription drugs (46%) or seeing new medical care providers (51%). A similar number (46%) say their personal financial situation has changed in the past year. These are all good reasons to reconsider your coverage options.

Next, determine whether coverage under your current Medicare plan is changing for 2023. Read through the “Annual Notice of Change” you should have received in the mail from your insurance company. Out-of-pocket costs and plan benefits may be changing. This year’s plan may not necessarily be the best choice for the year to come. Even if you prefer to keep the same insurance company, they may have a new plan better suited to meet your personal needs or preferences.

Read: Sticking with your Medicare plan this open enrollment season? You could pay a hefty price.

Compare your plan options

When you’re ready to compare Medicare insurance plans available in your area, look beyond monthly premiums to deductibles and other out-of-pocket costs you may face when receiving medical care. For any plan you’re considering, be sure you could afford the maximum out-of-pocket costs in case you’re hospitalized or suffer a serious health setback.

Make certain your new plan covers the doctors, hospitals, and pharmacies you value most. Provider networks can change from one year to another, and some plans may require you to visit in-network providers to receive the highest level of benefits. If you spend part of the year in one state and part in another, you’ll want to have access to medical care in both locales.

Consider prescription costs

One of the biggest concerns for many of us is the cost of prescription drugs. Even if some of your Medicare expenses (like Part B premiums) are going down in 2023, that doesn’t mean you won’t feel the pinch of inflation when it comes to prescription drugs or over-the-counter medical supplies. Make sure you only enroll in a Medicare Advantage or Part D prescription drug plan that covers the drugs you need at a price you can afford.

When it comes to prescription drug coverage, comparison shopping can save you money. Make a list of your personal drugs and dosages and compare how much you’ll pay for these under competing Medicare plans. Online comparison tools and licensed agents can help you do this. Finding the optimal plan for your prescription drugs can save you hundreds of dollars per year.

Get personal help – if you need it

Online plan comparison tools are great, but what if you want personal help or advice? Beware of scammers offering Medicare solutions that sound too good to be true and paid product endorsements from celebrities you may see on advertisements. 

Make sure you work with a licensed agent or reputable online broker that has the capabilities to compare and contrast multiple plan options. Find one that offers plans from competing insurance companies in your area. A licensed agent can answer your questions and help you understand how different plans work. It should never cost you anything extra to enroll through a licensed agent.

Here’s a last bit of friendly advice: Don’t put it off until the last minute. More than a third (36%) of the Medicare beneficiaries we surveyed don’t know that Medicare’s annual enrollment period is happening now. Annual enrollment continues through Dec. 7, but in the final week it can be hard to speak with a licensed agent. So, set aside an hour tonight to give yourself a Medicare coverage checkup.

Fran Soistman is chief executive of eHealth Inc.

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