Do I need to update my Medicare plan every year?

Yes. Medicare plan coverage can change yearly. That’s why all beneficiaries should review their plan benefits regularly to make sure they still fit their needs.

Yet, a surprisingly small number of people take the time to evaluate their plan annually. According to the Kaiser Family Foundation, during the 2021 Open Enrollment period, only 57% of Medicare enrollees reviewed their existing plan for changes in premiums or out-of-pocket costs, and less than a third compared their plan with other available options. 

Why review your Medicare plan annually?
If your current plan isn’t working for you, you have choices. A new plan may cost less, cover the medications you need and offer greater flexibility in the doctors you see. Some plans even include benefits not covered under original Medicare—such as dental, vision and hearing.

When can I make changes?
Each fall, Medicare recommends reviewing your plan and any notices you’ve received. Then, during the Annual Open Enrollment Period (October 15–December 7), you can:

• Switch between original Medicare and a Medicare Advantage plan

• Change from one Medicare Advantage plan to another

• Join, switch or drop a Medicare Part D drug plan

• Add or remove drug coverage from a Medicare Advantage plan

Any changes you make will take effect January 1 of the following year.

The cost of not reviewing your plan

According to Samuel Kina, SVP of Economics & Research at Picwell, Inc., Medicare choice errors—such as enrolling late or choosing the wrong plan—can be costly. These mistakes have long-term financial consequences.

Medicare expert Ari Parker, JD, shares this example in his book “It’s Not That Complicated: The Three Medicare Decisions to Protect Your Health and Money:” 

“At one of our recent Medicare Made Simple presentations, a 72-year-old attendee, Diane, was getting ready to retire and wanted information on how to apply to enroll in Medicare. She loved her employer-provided coverage. And she assumed, because she had worked continuously past age 65, that she could delay taking Medicare without hassle.”

When she went to enroll, she learned two things:

• She wasn’t eligible for a Special Enrollment Period because her employer only had 18 employees.

• Because she missed her enrollment window, she now faces a 70% late enrollment penalty on her Part B premium—for life.

Stories like Diane’s aren’t rare. Kina notes that only 10% of older adults choose the most cost-effective plan. On average, people overspend by more than $1,000 a year, and more than 10% overspend by over $2,000.

The good news: you can avoid these costly mistakes simply by reviewing your Medicare coverage each year.

Your 6-step Medicare coverage check

A quick 10-15 minute review can help you determine whether to stay with your current plan or switch. Ask yourself:

1. Have your health needs changed in the past year? For example, did you sustain an injury that requires ongoing care, or were you diagnosed with a chronic illness? This may require different coverage.

2. Are your doctors still in-network? Networks change yearly, especially with Medicare Advantage plans, so you’ll want to see if you can stick with the same doctors.

3. Are your prescriptions covered? Make a list of the medications you take and check them against the formulary for your Part D or Medicare Advantage plan with prescription coverage. Insurance carriers publish their drug list each fall.

4. Do you need additional benefits—for example, dental, hearing, or vision? These services have very limited coverage under original Medicare. If you think you’ll need these coverages in the coming year, you may want to look into a Medicare Advantage plan that offers them.

5. Will you be traveling a lot next year? If you have original Medicare, you’re covered nationwide for any provider that accepts Medicare. But if you have a Medicare Advantage plan, your coverage may be restricted to a certain geographic area. You can avoid high medical bills by making sure your Medicare plan follows you wherever you go.

6. Has your budget changed? Consider how your plan fits into your current budget, and whether you need something more affordable. In addition to the monthly premium, you’ll want to consider other out-of-pocket Medicare costs such as deductibles, coinsurance and co-payments. 

Comparison shopping—especially for Medicare Advantage—can reveal better coverage at a lower cost.

Who can help?

There’s no one-size-fits-all Medicare plan. Everyone’s needs are unique, which is why it’s important to do your homework before enrolling.

For free, unbiased help, contact your local State Health Insurance Assistance Program (SHIP).

• In Mesa County, call 970-243-9839, ext. 1 
• In Montrose and Delta, call 970-765-3129

YOU MAY ALSO LIKE:

Comprehensive Medicare coverage: How Select Health supports seniors

Get top-notch advice on choosing the right plan and learn about the benefits offered. Read More » 

Stop Medicare Fraud Before It Starts

Medicare fraud costs American taxpayers billions of dollars every year. By staying vigilant and protecting your Medicare information, you can help stop fraud before it starts.Read More »