4. Compare monthly premiums: During the AEP, it's a good idea to compare monthly premiums for the Medicare Advantage plans and prescription drug plans available in your area, because the monthly costs can vary tremendously. In 2013, premiums for Medicare Advantage plans range from $0 (above what you already pay for Medicare Part B) to over $350 a month. More expensive plans may have richer benefits, but all plans have a maximum out of pocket limit of $6,700, or less and most include prescription drug coverage (see eHealth study). Similarly, stand-alone Medicare Part D plans can cost as little as $16 per month, or as much $165 per month. Again, more expensive plans may have richer benefits, but all plans must meet Medicare's minimum quality standard and cover at least two drugs that have been approved to treat every major illness. If you don't compare benefits, premiums and covered drugs side-by-side, you may miss out on plans that could save you money.
5. Pay close attention to a Medicare Advantage plan's maximum out-of-pocket (MOOP) limit: One critical benefit of Medicare Advantage plans is that they cap your maximum out-of-pocket costs at $6,700 or less. In 2013 the average MOOP limit will be $4,516, but some plans have caps as low as $500 for services received "in-network." In exchange for a lower MOOP limit, Medicare Advantage plans may increase your cost sharing for a limited number of services. For example, plans may require you to pay a little more for inpatient mental health services than Medicare does. During the AEP, research the plan's MOOP limit and be sure you could cover those out-of-pocket costs in the event of an emergency.
6. Pay attention to a Medicare Advantage plan's provider network: The out-of-pocket maximum on Medicare Advantage plans can provide excellent protection against unexpected costs, but you'll typically have to use the plan's provider network to maximize that benefit. The majority of seniors (seventy-seven percent) consider having access to their existing primary care physician a very important factor when selecting a health insurance plan, according to an Opinion Research survey sponsored by eHealth. And, nearly two-thirds of the seniors in the survey (sixty-three percent) said they wouldn't change doctors, even if they could save over $100 per month. If keeping your doctor is worth $1,200 (as referenced in the example) a year to you, be sure your doctor accepts the Medicare Advantage insurance you're considering enrolling in during the Annual Enrollment Period.
7. Be aware of your "trial right" to use Medicare Advantage: Medicare Supplement plans (also called Medigap) typically provide very comprehensive benefits, with limited or no out-of-pocket costs. But, they tend to cost more each month than Medicare Advantage plans. And Medigap premiums tend to increase as a person ages (see study). If the monthly cost of your Medigap plan is starting to be more than you can afford, know that Medicare gives people a "trial right" to try Medicare Advantage. If you don't like it for any reason, you can switch back to the same Medigap plan, provided you do so within one year. If you want to give Medicare Advantage a try, the Annual Enrollment Period is the time to do so.
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