October 15–December 7 is Medicare's annual "open enrollment" period. This is when you can switch plans. Are you getting a lot of mail about the cost savings of Medicare Advantage (MA)? The initial outlay may seem less than your current plan. And if you have "original Medicare," plus a supplemental plan for the 20% Medicare doesn't cover, and prescription coverage, bundling it all together is tempting.
Contrasting the options. There is no doubt that having facilities (Medicare Part A) and providers (Part B) and prescriptions (Part D) all through the same company offers simplicity. In theory, one payment covers everything. There's no need to shop for supplemental insurance or track whether the insurer paid its part of a bill. But it's not an apples with apples comparison. MA plans have some serious drawbacks:
No looking back. If you leave a supplemental program paired with original Medicare, there may be no way to return. The plan may no longer be offered. Or you may fall within a "preexisting condition" category that allows the plan to refuse you or significantly raise rates.
If you are considering a change, even from one MA plan to another, be sure to compare apples with apples by running through some hypotheticals. What would your out-of-pocket expenses be if you were hospitalized? Or in skilled nursing? Are your favorite doctors and hospitals in the network? What if you were traveling and got sick or injured? What are the likely costs by the end of the year for the medication you currently take?
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Mary Dale Lancaster
10/7/2022 10:55:10 am
Great article - so many people love the lower premiums until they need a service that they cannot access.
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Leslie Alin Tewes is a Geriatric, Disability & Medical Care Manager; Elder and Adult Care Advocate; Quality Improvement Specialist.