Medicare Annual Enrollment is an important time of year for Medicare beneficiaries. Each fall, you have an opportunity to review your current Medicare coverage and determine whether another plan may better fit your healthcare needs for the upcoming year.
One of the most important steps you can take before reviewing your options is also one of the simplest: make sure your doctor and medication information is up to date with your Medicare broker.
Your doctors, prescriptions, pharmacies, and healthcare needs can change throughout the year. If your broker is working with outdated information, you may not get an accurate picture of how different Medicare plans could work for you.
Why Your Doctor Information Is So Important
Not all Medicare plans have the same network of doctors and healthcare providers.
If you have a primary care physician, specialists, hospitals, or other healthcare providers you want to continue seeing, your broker needs accurate information to help evaluate your options.
Before Annual Enrollment, consider providing your broker with:
- Your primary care doctor’s name
- Names of your specialists
- Any hospitals or healthcare systems you regularly use
- Other important healthcare providers
- Your preferred pharmacy
This information can be especially important if you’re considering a Medicare Advantage plan, because network participation can vary from one plan to another.
Even if you have been seeing the same doctor for years, don’t assume that your doctor’s participation will be the same in the coming year. Provider networks and plan contracts can change.
Your doctor may be in-network with one plan but not another. Knowing which providers are important to you allows your broker to include that information when reviewing your options.
Don’t Forget Your Medications
Your prescription medications are another critical part of the Medicare plan review process.
Medicare prescription drug coverage can differ significantly between plans. Plans may have different formularies, tiers, copayments, coinsurance, deductibles, and preferred pharmacies.
That’s why it’s important to provide your broker with a current list of all medications you take.
For each prescription, try to provide:
- The medication name
- Dosage
- How often you take it
- The quantity you typically receive
- Whether it is a brand-name or generic medication, if known
- The pharmacy you normally use
A medication that costs very little under one plan could cost considerably more under another.
Likewise, a medication that is covered by your current plan could have different coverage rules under a new plan.
Your Medication List May Have Changed Since Last Year
It’s easy to assume that your prescription list hasn’t changed much, but take a few minutes to look at it carefully.
During the past year, you may have:
- Started a new prescription
- Stopped taking a medication
- Changed dosages
- Switched from a brand-name drug to a generic
- Started taking a specialty medication
- Changed pharmacies
- Begun taking a medication prescribed by a specialist
Even one new prescription can potentially affect which Medicare plan is most appropriate for you.
Don’t rely on last year’s medication list. Give your broker the most current information available.
What Happens If Your Information Is Outdated?
Imagine that you have been taking three medications for the past several years. Your broker reviews plans based on those prescriptions and identifies an option that appears to be a good fit.
But you recently started taking a fourth medication and forgot to mention it.
That medication could have a different coverage tier, restrictions, or cost under the plan being considered.
The same principle applies to your doctors. If you recently started seeing a specialist and that doctor isn’t included in a particular plan’s network, that could be an important consideration when comparing your options.
The more accurate the information you provide, the more meaningful your plan comparison can be.
Annual Enrollment Is About More Than Your Premium
When comparing Medicare plans, it can be tempting to focus primarily on the monthly premium.
But the lowest premium doesn’t necessarily mean the lowest overall healthcare costs or the best coverage for your individual situation.
You should also consider factors such as:
- Your doctors and healthcare providers
- Prescription drug coverage
- Drug costs
- Pharmacy networks
- Deductibles
- Copayments and coinsurance
- Provider networks
- Maximum out-of-pocket costs
- Additional benefits
- Coverage rules and restrictions
Your personal healthcare needs should be at the center of the review.
Give Your Broker Plenty of Time
Medicare Annual Enrollment can be a busy time for beneficiaries and Medicare professionals alike.
Instead of waiting until the last minute, consider contacting your broker before Annual Enrollment begins and providing your updated information.
This gives you time to:
- Gather your current medication list.
- Review your doctors and specialists.
- Confirm your preferred pharmacy.
- Discuss any changes in your healthcare needs.
- Review your Medicare options.
- Ask questions about plans you are considering.
- Make an informed enrollment decision.
Starting early can make the process much less stressful.
Your Healthcare Needs Can Change — And Your Medicare Plan Should Be Reviewed Too
One of the biggest mistakes Medicare beneficiaries can make is assuming that because a plan worked well last year, it will automatically be the best choice next year.
Your health needs may change. Your medications may change. Your doctors may change. And Medicare plan benefits, costs, networks, and formularies can change from year to year.
That’s why reviewing your coverage during Medicare Annual Enrollment is so important.
Updating your information allows your Medicare broker to look at your situation as it exists today, rather than relying on information from a previous year.
A Simple Pre-Enrollment Checklist
Before meeting with your Medicare broker, gather the following information:
Doctors
☐ Primary care physician
☐ Specialists
☐ Preferred hospital or healthcare system
☐ Other providers you want to continue seeing
Medications
☐ Prescription names
☐ Dosages
☐ Frequency
☐ Quantity
☐ Brand or generic status, if known
Pharmacy
☐ Preferred pharmacy
☐ Mail-order pharmacy, if applicable
Other Changes
☐ New diagnoses or healthcare needs
☐ New prescriptions
☐ Discontinued medications
☐ New doctors or specialists
☐ Changes in where you receive care
Having this information ready can make your Annual Enrollment review more productive.
Don’t Wait Until the Last Minute
Medicare Annual Enrollment provides an opportunity to review your coverage for the coming year. But choosing a plan shouldn’t be based on a quick comparison of monthly premiums alone.
Your doctors and prescriptions are a major part of your healthcare picture.
Before you meet with your Medicare broker, take a few minutes to update your doctor, specialist, medication, and pharmacy information. It can help ensure that the plans being reviewed are evaluated against your current healthcare needs.
If you haven’t reviewed your Medicare coverage recently, Annual Enrollment is a great time to start.
Ready for Your Medicare Annual Enrollment Review?
Don’t wait until the last minute. Contact your Medicare broker and provide your current list of doctors, specialists, prescriptions, and pharmacies.
The more accurate your information is, the better prepared you and your broker can be to review your Medicare options for the upcoming year.