How to Evaluate Your Medicare Coverage: Tips for Annual Reviews

Maximize Your Benefits by Reviewing Your Plan Annually

Regularly reviewing your Medicare coverage is an important step to ensure that you continue to receive the best care at a reasonable cost. The annual review process allows you to reassess your current healthcare needs and financial situation, which can change over time. Here’s why and how to evaluate your plan:

Why Annual Reviews Are Essential: Economic pressures, such as rising inflation, have pushed more seniors to prioritize cost over the choice of doctors when selecting their plans. Annual reviews can help you determine if your current plan still aligns with your financial situation, particularly as healthcare needs evolve with age. The 2023 data shows that only 39% of Medicare users research their plan before enrolling, which can lead to suboptimal choices. This makes it even more critical to conduct an annual review.

Steps for a Successful Review:

1. Assess Your Current Plan: Review your current Medicare plan, whether it's Original Medicare or Medicare Advantage, and identify any gaps in coverage that have become problematic over the past year.

2. Compare Costs: Take note of any changes to premiums, deductibles, or co-pays for the upcoming year. Medicare Advantage plans may offer out-of-pocket maximums that can provide financial predictability.

3. Check Provider Networks: If you have a Medicare Advantage plan, confirm that your preferred doctors and healthcare facilities are still within the plan’s network.

4. Evaluate Prescription Drug Coverage: If you have a separate Part D plan, make sure it continues to cover your medications affordably. Review the drug formulary for any changes that could affect your costs.

Expert Tip: Medicare Advantage enrollees are more likely to conduct thorough annual reviews compared to Original Medicare users. This proactive approach can lead to better plan selection and cost savings.

Key Takeaway: Conducting an annual review of your Medicare plan can help you adapt to changes in both your healthcare needs and the healthcare landscape, ensuring that you are always on the most suitable plan. 

Written by Gennady