[ad_1]
Marcos Elihu Castillo Ramirez | iStock | Getty Images
You may have heard that if your Medicare Advantage 2021 plan isn’t right for you, there is something you can do about it.
During a window of opportunity that opened on January 1 and ends on March 31, Advantage registrants can abandon their plan and return to Basic Medicare (Part A hospital coverage and Part B outpatient care) or upgrade to another Advantage plan. If the latter is your preference, there are a few things to watch out for before finalizing your choice, experts say.
“Know that you are now locked into this plan for the rest of the year, unless you [qualify] for a special election period, ”said Danielle Roberts, co-founder of insurance company Boomer Benefits.
“Given the blocking period, due diligence is necessary,” said Roberts.
More from Personal Finance:
Here’s how you could cut some Medicare costs
Avoid Costly Mistakes When Transferring 401 (k) to an IRA
What to say to your adult children when planning your estate
About 63 million people are enrolled in Medicare, the majority of whom are 65 or older, according to government data. The rest are younger people with disabilities or people with end-stage kidney disease.
About 40% (25.4 million) receive their benefits through Advantage plans, which are offered by private insurance companies and typically include Part D. The remainder stick to Basic Medicare and may combine it with a plan. Autonomous Part D and a Medicare supplemental policy (aka Medigap), which are also offered by private insurers.
While Medicare’s annual fall enrollment serves to modify your coverage if desired, some beneficiaries find out only after the fact that the Advantage plan they’ve chosen isn’t ideal.
“The most common reason people change is because they joined a plan during [fall enrollment window] without realizing that one of their doctors is not in the network or that one of their medications is not covered on the formulary, ”said Roberts.
Your evaluation shouldn’t stop there, however.
For 2021, the average beneficiary has access to 33 Advantage plans, according to a study by the Kaiser Family Foundation. In total, 3,550 of these plans are available, up 13% from 2020.
Of the plans that include coverage for prescription drugs, more than half (54%) charge no premium and 96% of beneficiaries have access to one in 2021, according to Kaiser.
Premiums aren’t the only aspect to take into account: Generally speaking, the lower the premium, the more you will pay in cost sharing, i.e. copays, coinsurance and deductibles.
Additionally, although Advantage plans come with personal maximums (unlike Basic Medicare), these amounts can reach $ 7,550 in 2021 for network coverage before the plan pays for 100% of covered services. The combined maximum inside and outside the network is $ 11,300.
It’s also important to understand the differences between a PPO and an HMO, Roberts said. HMO plans provide coverage only if the providers are networked and are often cheaper. However, they may also have more requirements, such as needing a referral to see a specialist.
“This can sometimes slow down how quickly you can see a specialist, so you have to take that into account,” Roberts said.
Also, depending on your specific situation, you should check the network coverage of medical device providers, diabetes management providers, and home health companies, Roberts said.
“If you use any of these services, it’s a good idea to check with these providers to make sure you won’t lose access to them when you switch,” she says.
[ad_2]
Source link