If you’re on Medicare, Annual Enrollment (October 15–December 7) is your once-a-year chance to make sure your coverage still fits your health, your doctors, and your budget.

Even if you’re happy with your plan, it can change. Premiums, drug formularies, networks, and extras can change every year.

A quick yearly check can save you money, protect your access to care, and keep you from unpleasant surprises when January rolls around.

What Can Change (and Why You Should Care)

Medigap, Medicare Advantage, and prescription plans seldom stay the same from year to year.

Common changes include:

• Drug costs and tiers: Your medications may move to a higher tier or need prior authorization.
• Doctor and hospital networks: Your favorite doctor or most convenient hospital may no longer be in network.
• Premiums, copays, and deductibles: Small increases in these out-of-pocket costs can add up fast.
• Benefits: If you have a Medicare Advantage plan, dental, vision, and over-the-counter allowances can expand—or disappear.

Don’t like unpleasant surprises? A 30-minute review with us can help you be sure your coverage is right for you.

First, Do a Simple Needs Assessment

At Goodell Health Services, we begin with a needs assessment every year:

• Doctors: Who do you see now? Any new specialists?
• Prescriptions: Name, dosage, and pharmacy.
• Changes in Your Health Care Needs: Any new diagnoses, upcoming surgeries, or tests coming up?
• Budget: Are your monthly premiums, deductibles, and copays still a good fit for your budget?

This helps us compare your current coverage with what’s available for next year.

Know Your Options

 You’ve got a lot of choices when it comes to your Medicare coverage. It can be easy to get confused about the difference between these coverage options.

First, let’s do a quick review:

• Medicare Advantage (Part C):Medicare Advantage plans combine your medical and prescription coverage into a single policy. Most plans include coverage for prescriptions, eye and dental care, and other benefits.These work much like an HMO or PPO plan. You’ll have a limited provider network (or pay extra to go outside the network).
  
  On the plus side, Part C plans usually don’t charge an additional premium. You’ll still have deductibles and co-payments, but your annual out-of-pocket expenses will usually be capped.
• Original Medicare (Part B) + Supplement (Medigap) + Part D:
  
  Medicare Part B covers 80% of allowable office and outpatient services.

There are no network limitations. You can go to any provider who accepts Medicare.

Most people also choose an additional Medicare Supplement policy (a.k.a. Medigap) to help cover out-of-pocket costs, especially since Part B only covers 80% of treatment costs.

Since Part B doesn’t cover prescriptions, you’ll also need a separate Part D policy. The premium and co-payments will vary depending on which (if any) medications you take.

Can’t I Just Stay With My Original Plan?

So why not just pick a plan when you sign up for Medicare…and stick with it? There are several reasons to re-evaluate your Medicare coverage:

• Your budget, lifestyle, and health care needs change as you get older. What works when you’re 65 may not be the best option in 5, 10, or 20 years.
• Coverage areas and provider networks for Medicare Advantage plans can change every year.
• Medicare Supplement premiums tend to increase as you get older. A Medicare Advantage plan might be more cost-effective for your health needs.
• Drug coverage can change each year, as can your prescription drug needs.

Annual Enrollment isn’t switching for the sake of switching. It’s about making sure your plan still works for your health needs.

A quick review can save you major headaches in the future…and may also uncover significant savings.

Visit goodellhealthsolutions.com to schedule your Annual Enrollment checkup today. Bring your current policy information and your list of doctors and prescriptions; we’ll handle the rest.

Scott Goodell

Goodell Health Solutions

We Put the “Care” in Medicare