Millions of seniors are currently amid Medicare’s open enrollment season (from October 15 to December 7), but many find the process challenging. According to research from health care consulting firm Sage Growth Partners, dated July 2022, some people don’t know the difference between Original Medicare and Medicare Advantage. Many people are overwhelmed by Medicare advertising, and just four in ten people check their plan alternatives yearly. Many people neglect to take advantage of Medicare open enrollment. They could determine whether their doctors would remain in their plan’s network for 2023 or look at other Medicare Part D drug coverage options. It’s important to avoid these typical Medicare open enrollment mistakes: FAIL TO CONTACT YOUR DOCTOR BEFORE 2023 In most cases, Medicare Advantage plan enrollees are restricted to seeing doctors who participate in their insurance network, and the providers included in any given network are subject to change. Check to see if your favorite doctors are included in the plan’s network in 2023 before deciding to stay with your current plan. Since websites and provider directories are only sometimes accurate, you may have to put in some extra effort to accomplish this. According to Florida Healthcare Insurance President Evan Tunis: “I was just with a customer whose plan stated that their doctor was not in-network. We had to call the provider and look for a different site on the network side to figure out what was going on.” The best action is to double-check with the doctor’s office over the phone. COMPARISON OF PRESCRIPTION DRUG PLANS Prescription medication coverage is provided by a commercial insurance company regardless of whether you have Original Medicare or Medicare Advantage. This insurance company can alter its coverage for prescription drugs each year. In 2023, the price of your typical prescription drug may increase, or an insurer may decide not to cover it (it may be possible to find cheaper coverage elsewhere). Checking Medicare.gov with your medication list can help you find the best plan. You can see your medication record by logging into your Medicare.gov account. An expert in Medicare economics and holder of a doctorate in health economics and nursing, Katy Votava, stated, “It makes buying for the next year a lot easier for them.” They need not painstakingly weigh out each component. FALSELY ASSUME ALL DOCTORS WILL ACCEPT YOUR PPO PLAN Preferred provider organization (PPO) plans are health insurance policies that allow their policyholders to visit non-participating doctors for a higher copayment. A common misconception is that those with Medicare Advantage PPOs can visit any doctor they like. However, carriers only sometimes accept coverage from outside their network. To avoid being billed by the plan, “providers can just refuse someone at the point of service,” Tunis explained. In Florida, for example, the Mayo Clinic is not accepted by most Medicare Advantage plans. Thus, patients with that type of coverage cannot make appointments there. According to Tunis, “the most reasonable solution” for those who want complete freedom in selecting their healthcare providers is to enroll in Original Medicare and add Medigap coverage. TRUSTING THE ADVERTISEMENTS You may have seen an influx of Medicare advertising during the Medicare open enrollment period. Many promote Medicare Advantage plans and their enticing features, such as lower or absent monthly payments and coverage for hearing aids, dental work, and eyeglasses. However, ancillary benefits aren’t the only thing to consider when shopping for health insurance. According to Votava, “most of the time, they don’t cover that much dental.” The coverage for hearing aids is quite limited and should not be used as a justification for switching plans. Votava emphasized verifying that the plan includes your preferred doctors and medications for the upcoming year. TAKING TOO LONG TO ASK FOR HELP It would help if you didn’t research Medicare until the last day or week of open enrollment, which closes on December 7. The State Health Insurance Assistance Program (SHIP) is a good resource if you need answers to your inquiries about purchasing health insurance. SHIP program counselors are happy to help Medicare beneficiaries at no cost, but they may be unable to meet your immediate need for assistance due to high caseloads. Some regions of the country have waiting lists of several weeks for their SHIP programs. You shouldn’t wait if you need help, Votava urged.
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