top of page
Return to this month's index page
This Month's Cover

Volume 35
Winter / Spring 2019

Outlook

eHealth Insights: Those on Medicare Advantage Get a "Do-Over" on Plan Choice

Medicare Advantage Plan

Starting January 1, 2019 there now is a new open enrollment period available to Medicare beneficiaries covered by a Medicare Advantage plan. Replacing the Medicare Advantage Disenrollment Period, the new open enrollment period will run between January 1 and March 31, when Medicare beneficiaries will have an opportunity to:

  • Switch to a different Medicare Advantage or Medicare Advantage plan with Part D prescription drug coverage (MAPD).
  • Drop a current Medicare Advantage plan and return to Original Medicare (Parts A and Part B).
  • Sign up for a standalone Medicare Part D Prescription Drug Plan (if they return to Original Medicare).

For this new open enrollment period, eHealth offers the following five consumer tips:

1. Revisit 2019 Coverage Options

Research shows that only 11 percent of Medicare beneficiaries switch to a new plan each year, meaning common changes to coverage, such as provider networks and pharmacies, premiums, deductibles and copays, can easily be missed and lead to higher costs or reduced benefits throughout the year. The new open enrollment period occurring between January 1 and March 31 represents a second opportunity for beneficiaries to compare their options for 2019 if the Medicare Advantage plan they’re currently enrolled in isn’t meeting their expectations, and to change to a plan that better meets their medical and financial needs.

2. Review Overlooked Changes to Drug Coverage

From year to year, insurance companies often tweak their drug formulary, or list of covered drugs and their costs. That can mean higher out-of-pocket expenses throughout the year. Research shows that shopping and switching to a plan that best covers beneficiaries’ medications can lead to significant savings. A recent analysis of more than 17,000 people using Medicare.com (a nongovernment site powered by eHealth) to compare Medicare plans found that fewer than 10 percent were enrolled in the lowest cost plan for their personal prescription drug regimen. Those who switched to their optimal drug plan stood to save an average of $611 per year. Among people with MAPD plans, the potential average annual savings was $865. For people with part D prescription drug coverage, savings amounted to $545 for the year.

3. Make Sure Preferred Doctors and Pharmacies are Still Covered

Health care providers (doctors and hospitals) and pharmacies that participate with Medicare Advantage plans can change from one year to the next, and sometimes people don’t realize a change has occurred until they make their next appointment or go to refill a prescription. The amount consumers pay out of pocket to get care from a doctor, hospital or pharmacy that does not participate with their plan will be higher than care received from a network provider. And some health insurers won’t cover out-of-network providers at all, except in an emergency.

4. Tap the Benefits that Matter Most

Medicare Advantage plans often provide additional benefits not covered by Original Medicare, such as fitness, dental, vision and hearing services. A lot of Medicare Advantage plans are expanding their extra offerings for 2019. According to eHealth’s analysis, more 2019 Medicare Advantage plans will offer coverage for things like transportation to the doctor’s office (37 percent of plans versus 28 percent in 2018) and meals at home when you return from a hospital stay (50 percent of plans versus 31 percent in 2018). Many are also offering more comprehensive dental coverage. The open enrollment period offers beneficiaries a chance to make sure they receive the benefits that matter to them most.

5. Work with a Professional to Understand Your Choices

To make sure they’re viewing a wide range of plans available on the market, Medicare beneficiaries have the option of working with an expert in Medicare products that represent more than just one insurance company – and it doesn’t cost anything extra. Some people want their coverage bundled together and focused on a specific geographical area. Others don’t mind having two or more separate policies if it gives them additional flexibility to choose doctors and travel. A licensed agent can help beneficiaries choose the best option for their needs, budget, and lifestyle from a wide range of options.