Choose a Medicare Advantage Plan: Avoiding Common Mistakes

Don’t Miss Medicare Advantage Enrollment Periods

Selecting a Medicare Advantage plan is an important financial and health decision. A thoughtful choice can protect your budget and helps ensure health insurance choices that meet your wellness needs. Here are some common missteps beneficiaries can make – and how to avoid them.

Medicare changes are only allowed during specific times of the year:

• Annual Enrollment Period (October 15 – December 7)
  You can switch Medicare Advantage plans or return to Original Medicare.
• Medicare Advantage Open Enrollment Period (January 1 – March 31)
  If already enrolled in a Medicare Advantage plan, you can switch plans or move back to Original Medicare.

Knowing these dates helps you avoid gaps in coverage and helps ensure you don’t miss opportunities to improve your plan.*

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Facing a Medicare late enrollment penalty

If you want to avoid common Medicare mistakes, timing matters. Delaying enrollment in Medicare Parts A or B can result in permanent late-enrollment penalties added to your monthly premium.

Most people can enroll during the three months before turning age 65 with coverage typically beginning the month they turn 65. Workers over 65 may delay enrollment without penalty if they are covered by an employer health plan from a company with at least 20 employees.

Once employment ends, there is an eight-month special enrollment window before penalties apply. If you miss that window, the cost can follow you for life.

Ignoring the Medicare Annual Notice of Changes

Each fall, your plan sends a Medicare Annual Notice of Changes (ANOC) document that outlines benefit and cost updates for the coming year. The ANOC can contain critical information about higher copays, formulary changes or network updates.

Review it carefully for common Medicare Advantage mistakes. Even small changes can have a meaningful impact on your healthcare access and budget.

Overlooking prescription drug coverage

Many Medicare Advantage plans include prescription drug coverage but not all plans cover medications the same way or at the same cost. Formularies, copayments and pharmacy networks can change every year.

To avoid unpleasant surprises, review each plan based on the specific medications you take. Revisit your coverage annually, even if you’re happy with the current plan. The Medicare Annual Notice of Changes can help: A plan that works well this year may not be the most cost-effective option next year.

Using the wrong comparison criteria

A plan that works well for a friend, spouse or neighbor may be entirely wrong for you. Choosing a Medicare Advantage plan is not one-size-fits-all.

Instead of comparing plans based on reputation or premium alone, evaluate them based on your doctors, prescription drugs and typical healthcare usage. Personalized comparison can lead to better outcomes and fewer regrets.

Failing to confirm doctor and hospital networks

Provider networks do not always stay the same. Doctors and hospitals can enter or leave a plan’s network from one year to the next. Before enrolling, confirm that your current primary care provider and specialists participate in the plan, as well as preferred hospitals or clinics.

Don’t forget about coverage for extras such as vision, dental and hearing services. These benefits are often included in Medicare Advantage but not in Original Medicare.

Contact Prominence Medicare for help

Choosing a Medicare Advantage plan is about balancing cost, access, coverage and peace of mind. With careful comparison and attention to detail, you can avoid common mistakes and select a plan that truly works for you. Call 866-747-8855 to join a Prominence Medicare Advantage plan during an enrollment period. The provider network presently offers members access to quality medical services in Florida, Nevada and Texas.

* All benefits not available on all plans