Nov 12

The 4 C’s of Choosing a Medicare Plan

This question came from Nicole during our Day of Service Shredding event and Food Drive in Missoula.

Q: My mother just turned 68 and she was recently diagnosed with diabetes and high blood pressure. As a result, she had unexpectedly higher doctor and prescription drug bills. Her doctor’s financial counselor suggested we re-examine her Medicare choices when the next open enrollment period begins so she can switch to a plan that better meets her health needs and her financial situation.

When is Medicare Open Enrollment this year and what suggestions do you have for us to consider?

A: This year’s Medicare open enrollment season runs from October 15 – December 7. If you’re 65 or over, you can review your Medicare options and change plans if you’d like. In fact, each year you have a chance to review your coverage and see what new benefits Medicare has to offer.

Generally speaking, if you’re satisfied that your current plan will meet your needs for the next year, you don’t need to make any changes. But if you need to find a plan that works better for you, be sure to spend time doing your homework during Medicare’s open enrollment so that you have the health and prescription drug plans that work best for you.

I encourage you to take some time to get to know how your Medicare works. Visit the AARP Medicare Question and Answer tool at www.aarp.gov/MedicareQA to find answers to common questions.

What to Consider When Selecting a Medicare Plan

You can compare Medicare coverage options on the Medicare Plan Finder at www.Medicare.gov. Click on “Find Health & Drug Plans.” When looking at your options, consider the four C’s: coverage, cost, convenience and customer service.

1. Coverage
Make sure that the doctors you see and the medications you take will still be part of your plan in the coming year. If upcoming plan changes affect your coverage, then it’s important to review other Medicare coverage options.

2. Cost 
Like most other insurance, Medicare does not pay for all your health care costs. You are responsible for paying for expenses such as deductibles, coinsurance and co-payments. If two or more plans seem to offer about the same coverage, consider choosing the plan with the lowest overall cost. Remember, don’t just look at the premium (monthly payment). Also consider the deductible (how much you pay out-of-pocket before insurance kicks in), and coinsurance and copayments (how much you pay out-of-pocket for each service like visiting a doctor or filling a prescription). Make sure to compare all of these features so you can find a plan that works for you and your wallet.

3. Convenience
Compare plans to see which doctors and hospitals are included in the coverage, as well as what local pharmacies participate. If you prefer mail-order pharmacies, check out which plans offer this option.

4. Customer Service
The Medicare plan finder tool on www.Medicare.gov provides a quality rating for each plan. The rating covers several aspects of each plan, including customer service, member complaints, drug pricing, managing chronic conditions and more.

All plans now cover certain preventive services at no cost to you, thanks to the Affordable Care Act. These include screenings like mammograms and colonoscopies and annual wellness visits with your doctor.

For one-on-one help with your Medicare decisions, contact The Montana State Health Insurance Assistance Program (SHIP)—a free health-benefits counseling and advocacy service for Medicare beneficiaries and their families or caregivers. A SHIP counselor can be reached at 1-800-551-3191.

Changes to plans can be made at Medicare’s website, www.medicare.gov

Do you have a question for AARP Montana? Send your question to “Ask AARP Montana” at MTAARP@aarp.org or 30 W 14th St., Helena, MT 59601 or call our toll-free hotline at 866-295-7278. As we receive questions, we will consult with both internal and external experts to provide timely and
valuable advice.

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