Keeping the wallet healthy during Medicare’s open enrollment period is no small task, given the dizzying array of plans available to many seniors.
Data from 22,000 online consumers who used eHealth Medicare’s cost-comparison tool last year indicated that just 5 percent were enrolled in the prescription drug coverage plan with the lowest total out-of-pocket cost. “And these are people who are coming to the site and entering specific prescriptions,” said Ross Blair, senior vice president at eHealth Medicare, an online broker. “The (percentage) for the general population is probably even worse.”
Why the disconnect? Blair said some people entering Medicare were previously covered by employer insurance and simply aren’t used to this type of insurance shopping.“We’re just really not well-schooled when we reach retirement on how to do this,” he said.
Even if you’ve been satisfied with your health and drug coverage, you may benefit from reviewing your options. Shopping around may save you money or improve your coverage. “Their health may have changed in the last 12 months, their drugs may have changed in the last 12 months,” said Bob Moos, spokesman for the Centers for Medicare &Medicaid Services. “What may have seemed like the best choice a year ago may not be the best choice this year.”
Many plans change participating doctors each year, so if you want to keep your doctor, start there, according to the Medicare Rights Center, an advocacy organization.
The 2015 changes in premium numbers illustrate the value of shopping around, so dig out that annual change notice, which should have come in the mail in September.
Advantage plans have become popular with seniors on fixed incomes because they typically combine hospital and physician coverage with additional benefits, such as prescription drug insurance, preventive medical care, dental services and vision coverage.
However, Advantage plans have limited networks of health care providers, and doctors can drop out midyear.
Nevertheless, enrollment in the private Medicare Advantage plans is expected to grow by about a half-million to 16.1 million people in 2015 — about 30 percent of Medicare beneficiaries.
And remember that a variety of screening and wellness services are now free. Centers for Medicare and Medicaid Services officials said 18.6 million Americans took advantage of at least one such preventive service in the first seven months of this year.
Tips for plan shopping
Go online to research, or get a family member or friend to help, if you aren’t Web savvy
Narrow the field. Start by weeding out plans that don’t include your current favorite physicians.
Next look at drug plans and costs, based on your needs. To find out whether the drugs you’re taking will still be on your Medicare drug plan’s 2015 “formulary” (list of covered prescription drugs), go to www.medicare.gov and then click on “Find health and drug plans.” Answer a couple of questions and you will be able to compile a list of your drugs to see which plan covers them.
Consider all the factors in your drug costs, such as deductibles, co-payments and coinsurance.
Also consider the quality of a health or drug plan’s customer service. The medicare.gov plan finder provides star ratings for each plan.
Know the numbers. Estimate total cost, not premium alone. It may be easier to look at simple premiums than trying to estimate how much you’ll spend on the plan, a Part D prescription drug policy and a supplemental plan, for example, but the bottom line varies widely, depending on how you’ll use each policy.
Avoid scams. Don’t give out your Medicare number over the phone or in person in exchange for free equipment or services, or for “record keeping purposes.” For more information visit the government fraud website (below).
Phone numbers
Centers for Medicare and Medicaid: 800-633-4227 / TTY 877-486-2048
To see if a provider is Medicare approved: 800-MEDICARE (800-633-4227)/ TTY 877-486-2048
Medicare Right Center (has a help desk that assists seniors with choosing drug plans): 800-333-4114
Helpful websites
Centers for Medicare &Medicaid Services
medicare.gov/find-a-plan: Information and cost data
www.stopmedicarefraud.gov/preventfraud/scams-identity-theft/index.html
Cost changes, 2015
Medicare Part D prescription drug coverage, average monthly premiums increase by $1, to $32.
Part B premiums, no increase.
Average Medicare Advantage plan premiums: increase by $2.94, to $33.90
Medicare Part B monthly premium, $104.90, and annual deductible, $147, will remain the same as the last two years. Medicare Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment and other items.
Medicare Part A monthly premiums drop $19 in 2015 to $407. Medicare Part A covers inpatient hospital, skilled nursing facility and some home health care services.
Medicare Advantage plans average monthly premiums increase by $1.29 to $32.25. Advantage plans are essentially a private version of Medicare. Instead of paying beneficiaries’ claims directly, the government pays insurance companies to oversee the health care of seniors and people with disabilities.
Average monthly premiums for basic drug plans will rise $1.32 to $32.
Sources: Pamela Yip, The Dallas Morning News; Centers for Medicare and Medicaid Services; medicare.gov; Janet Kidd Stewart, Chicago Tribune
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