Thursday, March 26, 2020

How to Conduct a Medicare Advantage Plan Comparison for Your Aging Parent

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Once a Medicare plan is chosen, it cannot be changed until the next open enrollment period or unless you (or your loved one) experiences a qualifying life event. To make sure you choose the best plan for your unique situation, use the following steps to conduct a thorough Medicare Advantage Plan comparison.

1. Start by Understanding the Basics

All Medicare plans are broken down into parts A, B, C, D, and Supplemental. Each part covers a specific portion of your healthcare. They are broken down as follows:
- Part A provides coverage for long term medical care, including in-patient hospital stays, hospice care, or extended nursing care, both in a facility or inside your home.
- Part B provides coverage for regular doctors' visits and outpatient care, including office visits, tests, and outpatient procedures. 
- Part C, also known as a Medicare Advantage plan, provides the combined coverage of parts A & B, and many plans also include Medicare Part D. The Part C Advantage plans are often cheaper than purchasing plans from Parts A and B separately, and many Advantage plans offer optional add-on services, such as dental and vision. 
- Part D provides insurance for prescription drug coverage. Patients can purchase a Part D plan separately with either Part A or B, and some Advantage plans also include prescription coverage. Like most publicly available prescription drug coverage, Medicare Part D has a formulary that outlines the cost of specific medications and how much will be covered. 
- Supplemental plans provide additional coverage beyond what Parts A, B, C, and D cover. Purchasing a Medicare Supplement plan, also known as Medigap, can help defray out of pocket expenses, such as coinsurance or deductibles.

2. Compare Advantage Plans Available in Your Area

Available Medicare plans vary by geographic location, so you'll need to use a lookup tool to conduct your Medicare Advantage Plan comparison. By entering your zip code, county, and coverage year, you can explore the current plans available to you or your loved one. As you are working through your comparison, carefully consider the following aspects with each plan:
- Out-of-pocket costs: Different plans set different amounts for monthly premiums, original deductibles, coinsurance, co-pays, out of pocket maximums and overall maximum benefits. Some plans have lower monthly premiums but require higher deductibles and co-pays, while other plans will cover more of your out-of-pocket costs in exchange for a higher monthly premium. 
- Prescription coverage (Part D): Some Advantage plans include prescription coverage, while others do not. If you are prescribed regular monthly medications to maintain a healthy lifestyle, choosing an Advantage plan with prescription coverage included can help to keep your overall medical costs lower. 
- HMO vs PPO: Advantage plans follow the structure of typical HMO or PPO medical plans that you may have used in the past. Consider whether HMO vs PPO is better for your current situation based on your preferred doctor, monthly budget, and projected level of care. 
- Additional benefits: Some Advantage plans include additional benefits that are not included in Parts A or B, such as dental and vision care. As you see which additional benefits are available to you, consider which benefits will help to reduce your overall medical costs. 

3. Get Advice From an Expert

Although Medicare Advantage plans can lower monthly costs and provide additional benefits not offered in other plans, choosing the best plan for your unique situation can seem complicated. If you're not sure where to begin, find an advocate who can help you navigate the process and answer any questions. Enlisting the help of a Medicare expert can also save you considerable time and frustration as many qualified experts have comparison tools that can help you quickly identify which plan makes the most financial sense for you.