Mastering Medicare Planning
Open enrollment for Medicare is right around the corner, and people on all points of the spectrum should begin planning for it. If you’re in one of the categories below, you’ll especially want to continue reading:
- You’re already enrolled in Medicare and want to make sure that you’re in the right plan
- You’re eligible for Medicare and need to select your providers
We’re going to create a checklist of sorts for folks who are already enrolled in Medicare or need to sign up for a plan.
Note: We also have a webinar on this topic coming up, where we’ll go into all these points in far greater detail.
Prescription Drug Plans
Prescription drug plans are crucial for retirement planning because you may need very costly medicine in retirement. Each drug plan has different drugs that they cover, so you need to:
- Review your individual medication needs
- Find a list of prescription drugs that the plan covers
- Have an idea of when you need to have prescriptions filled
If you’re not on any medication, your choice may be easier than someone who is on a few medications. You’ll want to read through the prescription drug plan to ensure that the medicine you’re taking now is all covered under the plan.
Anyone who is planning on switching plans must be extremely diligent to ensure that the desired plan covers the drugs you’re taking.
Comparing Part D Plans
Part D is the prescription portion of Medicare. You’ll have one plan that covers hospital visits, one for doctor’s visits and another for prescriptions. If you worked through our first point, then you’ll need to compare drug coverage and the costs you will cover.
Imagine one person with high blood pressure and cholesterol. Their medicine may be covered on one plan. However, what happens if you also have arthritis and are on blood thinners? You’ll need to consider all these factors when making a choice on which Part D plan to join.
But what if you’re not on any medication?
If you’re not on medication, you need to really look at your risk factors when choosing a plan. Perhaps there’s a history of high blood pressure in your family, so you’ll want to find a plan that covers related medications.
Evaluating Your Pharmacy Network
Next, you need to consider each plan’s pharmacy network. If you go to your local Walgreens to have your prescriptions filled, you may not be able to fill them at Walgreens if they’re not a part of the Walgreens pharmacy network.
You should consider cost and convenience.
Is the plan that you plan on entering ideal for your location? Most people don’t want to drive 30+ minutes away once or twice a month for their prescriptions. Online prescriptions are becoming more popular; however, you do have to wait for the medicine to arrive, which can be inconvenient or completely impractical for certain illnesses.
Everyone should evaluate what they’re comfortable with in terms of the pharmacy network each plan offers.
Cost Analysis
Medicare plans are not free. In most cases, you’ll still pay premium cost and out-of-pocket cost.
If you want to have 100% of everything covered, you’ll pay more in premiums. Instead, you need to consider your medications and what the cost is for each of them. What if you have a very simple scenario where your prescription drug cost is very low? In this case, you may not need the most expensive plan.
What we are really looking at here is the “coverage gap” or “donut hole.”
These two terms mean that you need to analyze:
- Premium costs
- Prescription costs
- Income
If you do not have a lot of taxable income, this can work to your benefit and help you get into a more comprehensive prescription drug plan.
Annual Reviews
Annually, we recommend that you review your plan. One of the biggest Medicare mistakes we see is that people do not review their plans annually.
You might have been on the same plan for a decade, but switching plans can save you a lot of money. Some of the Medicare professionals that we work with have saved clients that we’ve worked with $2,000+ a year by simply reviewing and switching plans.
Dental, Vision and Hearing
Our second point revolves around parts of Medicare that are easy to overlook:
- Dental
- Vision
- Hearing
In fact, a lot of health insurance providers are severely lacking in these three areas of coverage, which can cause you to pay out of pocket for any related expenses.
Medicare requires you to think about the dental coverage you need and find a plan that will better meet your needs. Dental issues can spill over into your overall health issues, and you certainly want to maintain your eyesight and hearing, too.
Each of these elements deteriorates faster as we age, so this is an area that you need to focus on heavily.
Vision Coverage
Do you want your:
- Eye exams covered
- Lenses or contacts covered
You may want to cover these costs and forget about a plan that offers them. Why? You may compare plans and find that your premiums for vision coverage are much higher, and it’s more cost effective to cover these expenses on your own.
Hearing Coverage
If you think there’s a chance that you’ll need a hearing aid or screening in the future, then you’ll want to consider coverage for hearing. Otherwise, you may be fine without having hearing coverage as a part of your plan.
Integrative Plans
Finally, an integrative plan is when you look at all these items and come across Medicare Advantage plans. There’s a lot to look at with an Advantage plan. You may even find that a Gap plan is better for you.
Unfortunately, there are a lot of things to consider with integrative plans, but it’s something we’ll discuss in greater detail in our upcoming webinar.
Individual Needs Assessment
An individual needs assessment is an integral part of Medicare planning because what works for your neighbor may not work for you. Medicare is very individualized and will help you better understand your needs, true coverage needs, and potential future needs.
Medicare Supplement and Advantage Plans
We do want you to attend the webinar because these plans are so important for you to secure your retirement. Medical expenses can rise rapidly, and you need to be prepared to cover these costs.
In the webinar, we plan to cover:
- Medicare basics, such as supplements vs advantage plans
- State-specific coverages and differences
- Cost considerations
- Out-of-pocket costs
- Value of one plan to another
- Restrictions of each type of plan
- In-network and out-of-network differences
- Additional benefits of Advantage plans and if they offer the most coverage
- Getting access to personalized advice
We work with specialists who can help you make the best decision for your annual plan based on current and future medical needs.
During the webinar, we’ll be working with a Medicare expert who will answer all your questions and those that others have sent to us.
Want to learn more about Medicare planning?
Click Here to register for our “Medicare Webinar” on October 9th at 12:00pm EST. The webinar is 100% free, so feel free to invite your friends to listen to it, too