Albuquerque Journal

5 questions to help choose best Medicare plan

Open enrollment runs through Dec. 7; some homework can ensure the best coverage fit for you

- BY AARON BURTON N.M. MEDICARE SALES DIRECTOR, HUMANA

If you’re one of 56 million Americans eligible for Medicare, it’s important to understand coverage options when selecting your health plan for 2020. Research can take time, and many people find working with a licensed health insurance agent helpful when deciding between Original Medicare, Medicare Advantage plans, Prescripti­on Drug Plans and Medicare Supplement plans. Answering these five questions can help you make an informed choice during the Medicare Annual Election Period, Oct. 15 to Dec. 7:

1. Are my doctors, hospitals and specialist­s in network? Most Medicare Advantage plans offer online tools to help you find doctors and hospitals that are in a plan’s network. A licensed agent can also help you look up hospitals and doctors to see if they’re in a plan’s network and taking new patients, and confirm what’s in network if you’re a seasonal resident.

2. Which plans will cover my prescripti­on drugs? Original Medicare does not cover most prescripti­on drugs. Many Medicare Advantage plans include prescripti­on drug coverage, or you can sign up for a Part D Prescripti­on Drug Plan separately. A licensed agent can look up the medication­s you would like covered and help you estimate what the cost of each drug would be on a plan.

3. Are there new, innovative benefits I should consider? Beyond vision, hearing and dental coverage, if you aim to become healthier, look for fitness program benefits as many Medicare Advantage plans offer a gym membership. If you travel or appreciate technology, virtual doctors are helpful services when you can’t see a doctor right away. Most Medicare Advantage plans now offer transporta­tion to doctor appointmen­ts and the gym.

4. Will a zero monthly premium plan save me money? Private insurers help keep premiums down through programs like disease and chronic care management, which help people better manage health conditions and, in turn, reduce medical costs. You’ll still need to pay your Medicare Part B premium, which covers medical services and preventive care. You might want to use the additional premium dollars you save for out-ofpocket medical costs, such as co-pays.

5. Do I need to sign up for Medicare Parts A and B if I’m still working? If you or your spouse have health insurance from an employer, you can delay enrolling in Medicare until the employment or the coverage stops. At that point, you’re entitled to a special enrollment period of up to eight months to sign up for Medicare without incurring any late penalties.

Resources are available to help you in this process, including licensed sales agents, local seminars and websites As with any major decision, proper research will go a long way toward making the best plan choice for your personal health care needs.

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