INSURANCE

Q: My mother has Original Medicare. She is not as healthy as she once was, and her share of medical costs keep going up. Your thoughts? A:

Now is a good time for you and your mother to look at some of the alternatives to Original Medicare. Medicare Open Enrollment is going on now through December 7 so this is your opportunity to evaluate whether a Medicare Advantage Plan will be a better choice for her.

Here are some points to consider before choosing an Advantage plan:

Will your mother be satisfied with an Advantage Plan’s network?

With Original Medicare, your mother has the flexibility of choosing the physicians, specialists and other health care providers she prefers. Many Advantage plans have extensive provider networks, however you should make sure she will be satisfied being limited to the doctors, hospitals and other providers in the Advantage plan’s network that you select.

Prescriptions

Verify whether the plan’s prescription formulary covers the medications your mother is taking as well as the cost of each tier. (Each Advantage Prescription Drug plan has its own list of brand-name and generic drugs that the plan covers with drugs typically organized into tiers. Drugs in higher tiers cost more than drugs in lower tiers.) Ask if the Advantage plan will require prior authorization for prescriptions or whether there will be step therapy requirements.

Do you foresee any of these changes?

Is your mother likely to require a surgical procedure soon? Will she be spending significant time traveling abroad or living in another part of the country where she may need care? Will she require dental or vision care? Hearing aids? Any of these will affect the kind of coverage that will be best for her.

What is the cost?

Compare the monthly premium, deductible, copays and coinsurance of any Medicare Advantage plan to those of Original Medicare. Many seniors prefer an Advantage plan over Original Medicare because they offer more coverage and additional benefits with less out of pocket expenses. Medicare Advantage plans also provide an annual cap on out-of-pocket costs, while there is no cap on out-ofpocket costs with Original Medicare. You have until December 7, 2019 to change to a Medicare Advantage plan. Call me at 440-255-5700 or email me at Lmutsko@mutskoinsurance.com to help you make a change. I’ll help you find the right plan. Laura Mutsko Mutsko Insurance Services, LLC 6982 Spinach Drive, Mentor, OH 44060 440-255-5700 www.mutskoinsurance.com