Want to get the most from Medicare? An expert shares key advice

The time to assess your Medicare coverage options is upon us. From Oct. 15 through Dec. 7 each year, the Medicare Annual Enrollment Period provides an opportunity for existing Medicare enrollees to find the best fit for their unique needs.

Annual enrollment is the time to review and change Medicare Advantage (MA) plans and Part D drug coverage for the upcoming year. Because Medicare plans can change annually, it is essential to compare the costs and coverage terms of your current plan with other options available to you.

The process can seem complicated — but it doesn’t have to be. That’s why UnitedHealthcare turned to Medicare and retirement expert Phil Moeller to tackle some key topics that more than 77,000 Paste BN readers helped identify in an online survey taken in early August.

Approximately 40% of Medicare beneficiaries polled expressed concerns about choosing the best coverage for 2024. To help simplify the process and help you feel confident in your coverage decisions for next year, UnitedHealthcare brings you Moeller’s step-by-step guide:

Step 1: Review your current plan and coverage.

By the end of September, your current Medicare insurer(s) should have sent you details of any major plan changes for 2024, including costs and coverage terms. This document, called the Annual Notice of Change (ANOC), is usually provided online, but you have the right to ask for a paper copy.

You told Paste BN that access to in-network hospitals and doctors is the most important aspect in choosing a health plan. And your ANOC should alert you to important changes here. I recommend that you call your preferred doctors to confirm they will be in your plan next year. At the same time, ask them what other MA plans they will be working with, so you know you can keep seeing them if you decide to switch MA plans.

The availability and costs of prescription drugs are also a consideration for Medicare shoppers. Again, important changes to your prescription drug coverage — including what drugs are on your plan’s covered drug list (called a formulary) — should be explained in your ANOC. And it’s never a bad idea to call your insurer to confirm.

If you haven’t already done so, create a personalized My Medicare account, which should show your current Medicare plans. You can also input your medications, which will help you be a savvy shopper during annual enrollment.

Step 2: Compare plans available in your area.

Starting Oct. 1, all 2024 plan details should be posted at Medicare’s online plan comparison website. Wait until they are posted before doing any serious comparison shopping. There’s no reward for choosing new plans right away, so waiting until early November has always made sense to me. But — do what feels right for you!

On this website, you can compare 2024 plans available where you live, with search results outlining variables, such as premiums, projected drug spend, out-of-pocket costs and added plan benefits. When shopping, keep in mind that the out-of-pocket costs of all Part D prescription drugs will be capped next year under a provision of the Inflation Reduction Act. KFF, formerly called the Kaiser Family Foundation, projects the IRA will cap out-of-pocket drug costs at $3,250 in 2024 for people with the highest Part D spending. Its analysis also reviews the complexities of different stages of Part D coverage, should you need a refresher.

Step 3: Look beyond plan premiums.

While low or $0 plan premiums are enticing, it’s always important to compare plans based on potential out-of-pocket costs. Variables like deductibles, copays, coinsurance and out-of-pocket maximum have always been key factors for me in choosing a plan, and you should determine what matters most to you.

The Paste BNpoll found that for about 22% of those on Medicare, “extra benefits” are the most important factor in selecting a plan. Many people are surprised to find that Original Medicare doesn’t typically cover services, such as dental and vision, but many Medicare Advantage plans do. Or, if you are interested in added wellness offerings, such as a free gym membership, or things like over-the-counter credits or healthy food benefits, check to see what plans offer these extras.

Step 4: Don’t be intimidated, support is available.

Confusion about how to choose a plan and what to look for can make keeping your current plans seem like the safe choice. I get it, but my personal experience has convinced me to be an active shopper.

Consider this: I almost kept my existing Part D plan a few years ago, only to learn — and not until early December! — that it would no longer be covering an expensive drug I needed to take. I barely escaped a $20,000 mistake and urge you not to risk doing the same thing.

There is help for you in making the best of annual enrollment. The State Health Insurance Assistance Program (SHIP) provides free Medicare help from trained counselors in every state. Medicare Made Clear, maintained by UnitedHealthcare, provides solid help. So does Medicare, which has greatly improved its consumer assistance tools in recent years.

When it comes to getting your questions answered, take advantage of these resources to help you choose your Medicare coverage for 2024 with confidence.

About Phil

Journalist and author Phil Moeller has been writing about aging, retirement and health care on a full-time basis for more than 15 years, including as the principal author of the “Get What’s Yours” series of books about Social Security, Medicare and health care. Follow him on X at ‎@PhilMoeller, and for additional Medicare and health care content from Phil, visit ‎https://philmoeller.substack.com/.

Members of the editorial and news staff of Paste BN Network were not involved in the creation of this content.