As fall creeps up on the horizon, there’s something more important than putting away the patio furniture, gearing up for football season, or preparing to transition to your winter home: Medicare. Medicare Open Enrollment runs from October 15th to December 7th, and unless you qualify for a special enrollment period, it’s the only time you can join, drop coverage, or adjust your plan. However, don’t wait until mid-October to start thinking about the changes you want to make. Since Medicare Advantage and Part D plans frequently change coverage, costs, and provider networks, re-enrolling in the same plan may not mean you have the same coverage. The last thing you want to do is make a big decision about your healthcare needs without carefully considering all of the factors. Here are a few questions to ask now so you can be smart about Medicare, whether you’re shopping for coverage for yourself or for aging parents.
How Much Coverage Is Needed?
One of the first questions to ask when renewing coverage or enrolling in Medicare is, “Does this fit my needs?” This is one of the reasons why we recommend tracking your healthcare expenses throughout the year (it’s also important to do this if you have an HSA, so you can be reimbursed for qualified medical expenses). Calculating how much you spend on healthcare per year eliminates the guesswork of knowing how much coverage you need, especially if your healthcare expenses have increased since last year. Don’t forget to include any changes in health or medical conditions.
Is Your Plan Changing?
If you or your parent is already enrolled, you’ll receive two documents in September: the Annual Notice of Change (ANOC) and Evidence of Coverage (EOC). These documents disclose any changes in coverage or providers for the following year. Even if you’re happy with your current plan’s coverage and nothing is changing, it’s a good idea to shop around. Since plans change annually, there may be better options available for the coming year that weren’t previously available.
Which Options Work With Your Healthcare Provider?
If you decide to switch plans but want to keep your primary care physician, shop for plans that your doctor accepts. This is especially important if you’re caring for aging parents and helping them renew coverage. Having an established relationship with their care team, where your loved one’s medical needs are well understood, is a gift that can ease the responsibilities of caregiving. On the other hand, the Medicare open enrollment period is the perfect time to switch doctors if you aren’t happy with the care you (or your parents) are receiving.
Are Your Prescriptions Covered?
As you review your plan or shop for new options, do so with a full, updated list of your prescriptions nearby to make sure you’re getting as much covered as possible. If you’re helping a parent who is less open to assistance, this can be a less threatening way to help them manage prescriptions. Asking for a list so you can help them shop for health insurance is an easier pill to swallow than implying that they may not be able to manage their own medications safely.
How Does Your Coverage Fit With Employer-Provided Healthcare?
If you’re still in the workforce, consider which options will complement your employee healthcare. If your company has more than 20 employees, the coverage you have with them will most likely be your primary insurance. If they have less than 20, your Medicare coverage will be the primary insurance. With that in mind, compare the costs of each, and ask: Are your prescriptions covered? Are there any other gaps that you’d like to fill? Does your employer match HSA contributions? You can’t contribute to an HSA if you’re enrolled in Medicare; it may be worth delaying Medicare enrollment and owing a penalty to keep the flexibility of your HSA. Learn more about the triple tax advantage of an HSA here.
Finding the Right Medicare Fit
The right Medicare coverage can help free up the rest of your savings for the things that matter to you. Don’t pay more than you have to, and don’t stick with coverage that doesn’t work for you! If you’re new to Medicare, it can be a bit confusing, but if you need help, you can call 1-800-MEDICARE, visit Medicare.gov, or reach out to your local Social Security office.
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Material provided, in part, by Kalli Collective, an independent third-party, Raymond James is not affiliated with Kalli Collective.
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