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commentary - Avoid Medicare Advantage plan misconceptions

Marco Island Eagle - 10/13/2017

Understanding the resources and tools at your disposal will allow you to take "advantage" of all the benefits Medicare plans have to offer in 2018.

The Medicare annual election period takes place from Oct. 15 through Dec. 7. It's a time for people with Medicare to make important decisions about their health care – just ask the 17.7 million people who decided on a Medicare Advantage plan in 2016.

There are many factors to consider so that you get the Medicare plan that best meets your health and budget needs.

To navigate your health care options during this year's annual enrollment period, it is important to remember what not to do.

When researching Medicare plans, people often focus on premiums and medical provider networks, but may not realize there's more to consider. Knowing the benefits offered by Medicare Advantage plans and Medicare prescription drug plans, both of which offer enhancements to original Medicare, will also be pivotal in your decision-making.

While Medicare Advantage provides the same coverage as original Medicare, Medicare Advantage plans also often include predictable copayments, lower or no deductibles, Part D prescription drug coverage, out-of-pocket limits for financial protection, and low or even zero monthly plan premiums.

Some of these plans offer additional features designed to meet members' needs, such as dental, hearing and vision coverage, a nurse advice line available 24 hours a day, seven days a week, and fitness programs.

Here are five common hiccups Medicare beneficiaries may experience when considering their options in search of a Medicare Advantage plan that will help them achieve better health and well-being:

Your monthly payments are not the only thing to consider. While it's tempting to gravitate to a $0 or low-premium monthly plan, it's easy to overlook extra costs that can be incurred down the road, such as for hospital stays and medical procedures. After you analyze your previous year's plan and assess the most affordable option for the coming year, consider the total value of the Medicare plan you select, along with your health, medical and budget needs for the coming year.

Your drug coverage is not the same everywhere. Surprisingly, drug prices can vary depending on your location, pharmacy and how much you've used your prescription benefits over the course of the year. Be diligent by making a list of your medications; researching drug formularies – the list of drugs a Medicare prescription plan covers, and considering mail order as you evaluate your prescription drug plan options. Some plans may offer lower costs if certain pharmacies are used.

Your plan isn't just for medical visits or emergencies. If you are living with a chronic condition, you may want to look for plans offering personalized care in the forms of health coaching, education and support by registered nurses and other health professionals. Many Medicare Advantage programs also offer benefits, such as fitness programs, to help members maintain a healthy, active lifestyle.

You may not need the same plan as your spouse or significant other. Health needs vary and what works in your Medicare Advantage plan may not be the best option for your spouse. It's important for the two of you to sit down and assess your different health needs, health care providers and if your doctors will be covered in your plan. This ensures your Medicare plan makes sense for your individual health, budget and lifestyle.

You're not on your own in making this decision. Utilize resources, such as a licensed Medicare health insurance agent, Medicare.gov or Humana.com/Medicare, to help identify the best plan for you. Now, you also can call 1-800-MEDICARE (1-800-633-4227) or TTY, 1-877-486-2048, 24 hours a day, seven days a week for 2018 Medicare plan information. Or you can call Humana at 1-888-204-4062 (TTY users can use 711).

Understanding the resources and tools at your disposal will allow you to take "advantage" of all the benefits Medicare plans have to offer in 2018.

Galloway is Humana regional president for Central and North Florida.

Deb Galloway

Understanding the resources and tools at your disposal will allow you to take "advantage" of all the benefits Medicare plans have to offer in 2018.

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