A Last-Minute Guide to Shopping for Medicare

 Lisa Zamosky
  28th-Nov-2017

Medicare's annual open enrollment period is about to come to a close: Dec. 7 is your final chance to change from one Medicare Advantage or prescription drug plan to another. If you're currently enrolled in Original Medicare, you can also switch to a private Medicare Advantage plan or drop existing Medicare Advantage coverage to return to Original Medicare.

If you're like a lot of people, you've waited until the very last minute to shop your options. "We do see a lot of folks rushing at the end," says Joe Baker, president of the Medicare Rights Center.

There are a number of reasons for that, Baker says: inertia, fear or feeling overwhelmed with too much choice. "It's not the kind of shopping people like to do, and it's confusing," he says.

That's why many experts suggest you seek help, particularly as the time left to make a choice dwindles.

"When it's the last few days of annual enrollment and down to the wire, that's when beneficiaries can make costly mistakes rushing to pick a plan without help and guidance," says Joe DeLuca, director of sales at e Health Medi care.

Experts say Medicare beneficiaries have lots of questions about how to find the right plan. Here, experts answer some of the most common questions asked during Medicare annual enrollment.

If I'm happy with my coverage, do I really have to do anything?

"The simple answer is yes," says Nicole Durtiz, vice president of health education and outreach with AARP.

Here's why: Although you're not required to take any action to hold onto your current plan for 2018 (as long as it's still being offered next year), doing so without shopping your options could cost you. Changes that occur in Medicare Advantage and prescription drug plans each year can alter your coverage in ways that may no longer work for you or your wallet.

You may be happy with your coverage this year and assume it will be identical in 2018, Durtiz says, "but that's often not the case."

What people tend not to realize until it's too late is that their doctor is no longer covered by their plan, or that the medications they take have been moved to a different, higher cost drug tier, meaning higher out-of-pocket costs at the pharmacy. "They wouldn't know that until it's too late if they haven't done that investigation," Durtiz says. Her advice: "Spend a little bit of time making sure your needs haven't changed and the insurance company hasn't made a business decision that impacts your coverage."

What's the best plan for me?

"This is the most common question we get," Baker says.

Unfortunately, there's no one right answer. "We can't tell people which plan is the best of the best for them. It's an individualized decision," he says.

However, there are some rules of thumb to follow that can help you get at the right choice.

In many markets, you may have 30 or more plans from which to choose, so start by limiting your options to avoid feeling overwhelmed. You can do that by using the Medicare Star Ratings system, which rates plans on a scale of one to five stars, with five being the best, based on the agency's assessment of medical services and customer satisfaction. Filter out lower-rated plans and stick with just those that have received four and five stars. "That may be a way to cut the list in half," Baker says.

He also suggests having a conversation with your doctors or pharmacist. "They may steer you away from plans that don't do a good job covering the stuff you need," he says.

Durtiz suggests people focus on "the four Cs" to making shopping easier: cost, coverage, convenience and customer service

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