It’s that time of year when millions of Americans get a chance to select or switch their Medicare plan for the coming year.
Choosing a Medicare plan is one of the most important decisions people can make, not only for their health and well-being, but also for their budget.
The Medicare Annual Enrollment Period runs through Dec. 7 and is the opportunity for consumers to assess carriers’ new plans and make changes or confirm their coverage.
If anything has changed, either with a current plan, health status or budget, a decision to do nothing could lead to unpleasant surprises or missed cost-savings in 2022.
A good first step to help you make an informed decision is understanding the health-care terms “premium,” “deductible” and “co-insurance.”
Get the definitions at the website JustPlainClear.com.
Then, check your current coverage, make sure it still meets your health-care needs and see if your benefits will change. Does the plan still fit your budget?
Pay attention to more than just the monthly premium. Check other out-of-pocket costs, including deductibles and co-pays, as these costs can add up.
Knowing how to get the most out of prescription benefits may help manage the logistics and cost of medications.
Check with your health plan or doctor for lower-cost pharmacy options, including generics and mail order.
Original Medicare doesn’t generally cover prescription drugs.
Part D plans or Medicare Advantage plans can help keep medication costs in check.
Choose a plan that offers 24/7 virtual visits.
Talk to a doctor about common health issues in real time right from a device in the comfort of home.
Managing mental health is also important for a person’s well-being.
Many health plans will offer access to a large virtual health network of therapists and psychiatrists, along with in-person behavioral health care.
Some health insurers offer advocacy services to help members find the right therapist and care.
Expecting a big change next year like an upcoming surgery?
A good rule of thumb is to compare differences between plan designs and out-of-pocket limits.
Many health plans offer financial incentives for exercising, not smoking, even taking a health survey.
Many Medicare Advantage plans even offer gym memberships at no additional cost.
If you are already a Medicare beneficiary, visit the Center for Medicaid & Medicare Services (CMS) website at medicare.gov; call 1-800-MEDICARE 24 hours a day, seven days a week; or contact Medicare Advantage plans directly.
When ready to make your choice, call 1-866-964-1547, TTY 711, Monday through Friday, 8 a.m. to 5 p.m.
Optum disclosure: Calling these numbers may direct you to a licensed insurance agent.
(Dr. Ryan Tyner is the chief medical officer for Optum, New Mexico in Albuquerque.)