What are some good ways to get help choosing a Medicare
Advantage or Part D plan during open enrollment this year?
Open enrollment for Medicare Advantage and Medicare Part D runs
from October 15 to December 7, and there are a lot of great
resources to help you choose the best plan for you in 2013.
Instead of relying on all of the mailings, calls and seminars
offered by salespeople touting their companies' plans, check out
your options yourself. The best resource is Medicare's
Plan Finder
, a comprehensive list of the Part D and Medicare Advantage plans
(called "Medicare Health Plans") available in your area.
To compare the Part D prescription-drug plans, type in your zip
code, and then your drugs and dosages. The Plan Finder will show
the total out-of-pocket costs, including premiums, deductibles and
co-payments, you'd pay over the year under each plan. You might
find out that a plan with a low premium and high co-pays for your
drugs actually costs more over a year's time than a plan with a
higher premium and lower co-pays for the drugs you need. The tool
also shows whether a generic is available for any of your
medications; whether the plan offers lower rates for using a
mail-order or preferred pharmacy; and whether it imposes any
restrictions, such as requiring prior authorization for certain
drugs.
The Medicare.gov Plan Finder is also a great resource for
finding Medicare Advantage plans in your area. These plans provide
both medical and drug coverage from private insurers. The tool
shows the total costs for your medications, as it does with the
Part D plans, and it also lets you estimate your out-of-pocket
expenses based on your health status -- poor, good or excellent.
(The default status is "good" -- if you need to change it to "poor"
or "excellent," go to "change health status" in the "refine your
search" column on the summary of your search results page.) You'll
see details about the plan, including premiums, deductibles and
co-insurance; physician networks; out-of-pocket maximums; estimated
annual health and drug costs for your medications and health
status; and star quality rating (see
Medicare Advantage Star Ratings Can Help You Pick a
Plan
for more information about these ratings). Check the box by the
plans you're interested in, click on "compare plans," and you can
delve into the details about each plan's coverage and costs.
Helpful as it is, the Plan Finder tool can be complicated to
navigate, especially for elderly people who aren't used to working
with computers. You or your parent can get free personalized
assistance from the State Health Insurance Assistance Program
(SHIP), which provides phone and in-person consultations that can
walk you through the Plan Finder. The groups also hold community
seminars with general information about your options. Find your
local SHIP at
ShipTalk.org
or by calling 800-633-4227.
If you're looking for a Medicare Advantage plan, start with the
Plan Finder, which will provide information about the costs and
coverage. Then supplement that research by checking out
HealthMetrix Research's Cost Share Report, at
MedicareNewsWatch.com
. This report is not as comprehensive as the Plan Finder -- it only
includes about 100 cities -- but it provides valuable analysis,
listing the best Advantage plans by area based on estimates of
typical total costs for people in good, fair or poor health. The
Senior Choice Gold Awards recognize the Advantage plans with the
best value.
PlanPrescriber.com
(888-312-5447) can also help you compare costs and coverage for
Part D and Medicare Advantage plans. As with the HealthMetrix
report, this resource is less comprehensive than the Plan Finder,
but it is easier to navigate and also includes helpful information
about Medigap plans and premiums, which can be difficult to find
elsewhere. The phone reps can also answer questions about your
options.
For extra hand-holding -- or help with the bigger-picture
questions of how to get coverage in general -- consider a fee-based
service. Allsup Medicare Advisor charges $75 for help with Part D
and $175 for help with Medigap and Part D. The most useful of its
services, which costs $395, helps you decide whether to go with
traditional Medicare or Medicare Advantage and also reviews your
open-enrollment options for Part D and Medicare Advantage (
www.medicare.allsup.com
; 866-521-7655), an analysis the Plan Finder won't do for you.
Healthcare Navigation (
www.healthcarenavigation.com
; 877-811-8211) is pricier--$750 or more, depending on the
complexity of the situation--but it offers a comprehensive review
of Medicare and retiree health care and can provide advice about
your options if you continue to work past age 65 and need to make
decisions about pairing employer coverage and Medicare.
For more information about Medicare Advantage and Part D open
enrollment, see
Sift Through Your Medicare Choices
and
What to Know About 2012 Medicare Open
Enrollment
.