How to judge Medicare plans
While much of the nation is preoccupied with Obamacare and picking new health insurance at work, older Americans have deadlines of their own coming up — involving Medicare.
We're just a few days away from the two-month period when the nation's 54 million Medicare beneficiaries have a chance to change their Medicare Advantage and prescription drug plans.
Every year, seniors should review their options and compare plans even if they're happy with their current coverage. Experts want people to avoid being surprised after it's too late to change. The deadline is Dec. 7.
"It's the same advice we give every year, but it's hard to get people off the dime," says Ross Blair, senior vice president of eHealthMedicare.com, which provides tools and information on Medicare insurance issues.
According to the Centers for Medicare and Medicaid Services, the average premium for Medicare Advantage plans will increase less than $3 next year, to $33.90 per month. Residents of Los Angeles County will see average costs of just $13.74 per month. The vast majority of enrollees will face little or no premium increase for next year.
But out-of-pocket costs, such as deductibles and co-pays, are expected to rise. Looking beyond the monthly premium will be important for shoppers wanting to save money.
Be aware that some Advantage plans will be terminated this year. Be certain yours will continue;
Pay attention to networks, experts stress. Medicare Advantage plans are also reducing the size of their provider networks — in some cases quite dramatically.
If your physician will no longer be participating in your current plan, your insurer is required to send you notice of that fact and help you find another doctor in the network.
Nationwide, the average monthly premium in 2015 will be about $31, the federal government estimates. In California the figures vary, but the average is $58.91.
Although the number of these plans has dropped for 2015, there will still be 1,000 available nationwide. In Los Angeles County, Medicare participants will have 31 plans from which to choose for 2015, down from 34 this year.
As with Medicare Advantage plans, insurers are shifting more costs onto beneficiaries in the form of higher out-of-pocket costs, such as deductibles, co-pays and co-insurance, so you need to look beyond premiums.
Also, many plans have "preferred" status pharmacies, whose costs can be lower than other in-network pharmacies, says Elaine Wong Eakin, executive director of the Medicare advocacy organization California Health Advocates. In fact, 70% of Medicare drug plans had preferred pharmacy networks this year, and the expectation is there will be more in 2015.
Also, many plans have "preferred" status pharmacies, whose costs can be lower than other in-network pharmacies, says Elaine Wong Eakin, executive director of the Medicare advocacy organization California Health Advocates. In fact, 70% of Medicare drug plans had preferred pharmacy networks this year, and the expectation is there will be more in 2015.
Also, pay attention to the ratings. To help consumers determine the value of both Medicare Advantage and prescription drug plans, Medicare created a quality rating system. A plan can receive one to five stars, with five being the best, based on the agency's assessment of medical services and customer satisfaction.
Experts urge consumers to be alert for possible changes since last year's Medicare Advantage and prescription plans.
To review your plan options: Medicare plan finder at http://www.medicare.govor call (800) MEDICARE; eHealthMedicare.com.
For free personalized counseling services: State Health Insurance Assistance Programs, shipnpr.shiptalk.org or call (800) 677-1116; In Los Angeles, California Health Advocates: http://www.cahealthadvocates.org/HICAP
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