Reviewing Your Medicare Coverage — Has Anything Changed?
Medicare coverage isn’t something to choose once and forget. Plans, costs, medications, healthcare needs and provider relationships can change. A regular review can help you understand whether your current coverage still fits your situation before you decide whether any change is necessary.
Start With What You Have
Before looking at alternatives, understand your current coverage. Review your premiums, deductibles, copays or coinsurance, prescription drug coverage, provider access and other benefits that matter to you. Knowing what you already have creates a useful starting point.
Identify What Has Changed
Ask what is different from the last time you reviewed your coverage. Have your medications changed? Are your doctors and hospitals still available through your coverage? Have premiums or other costs changed? Has your health or the way you use healthcare changed? Your coverage may change—and so can your needs.
Decide Whether You Need a New Direction
A review does not automatically mean you should change coverage. If your current coverage continues to meet your needs, staying where you are may be one of the choices available to you. If something important has changed, understand your alternatives, applicable enrollment rules and effective dates before making a decision.
Things Worth Knowing
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Medicare Advantage and Part D plans can make changes from year to year, including premiums, cost sharing, covered drugs, pharmacy networks, provider networks and other plan features.
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Review the Annual Notice of Change (ANOC) and other information your plan sends you so you understand changes taking effect for the upcoming year.
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Prescription medications deserve their own review. Formularies, drug tiers, utilization requirements and pharmacy arrangements can change.
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Provider participation can change. If particular doctors, specialists or hospitals are important to you, verify their current participation directly with the plan and provider.
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Your own circumstances may change even when your coverage does not. New medications, diagnoses, travel patterns, financial circumstances or preferred providers may affect what is important to you.
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Medicare has specific enrollment periods and rules governing when coverage changes can be made. Not every change can be made at any time.
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Do not cancel existing coverage until you understand the effective date and requirements of any replacement coverage.