Do I Need to Review My Medicare Plan Every Year?
Four Things to Check Each Year to Make Sure Your Medicare Coverage Still Fits Your Needs
Yes. I recommend reviewing your Medicare coverage every year—even if you're happy with your current plan.
Medicare plans can change from one year to the next, and your health-care needs can change too. Premiums, prescription coverage, provider networks, copays, deductibles and benefits may not remain exactly the same.
One of the biggest mistakes I see is assuming, “My plan worked this year, so I'll just leave it alone.”
“The Medicare plan that worked for you last year still deserves a review this year.” — Charise Karjala
The review may show that keeping your current coverage makes perfect sense. The important thing is to make that decision after reviewing the facts—not simply by default.
The Charise 4-Point Medicare Review
1. Are My Doctors and Hospitals Accessible?
Check the doctors, specialists, hospitals and health systems that are important to you.
Provider networks can change. Don't assume that because you had access to a provider this year, the same arrangement will necessarily continue next year.
2. Are My Prescriptions Covered Appropriately?
Review your current medications, formulary coverage, drug tiers, pharmacy options and expected costs.
Your prescriptions may have changed—and the plan's coverage can change too.
3. What Is My Total Financial Exposure?
Don't stop at the monthly premium.
Look at deductibles, copays, coinsurance, hospital costs and other potential expenses.
For Medicare Advantage coverage, pay particular attention to the plan's maximum out-of-pocket limit for covered Part A and Part B services.
That number can change from year to year and varies among plans.
“Your maximum out-of-pocket amount isn't a footnote. It's part of your financial planning.” — Charise Karjala
4. Does My Coverage Still Fit My Life?
Your health, medications, doctors, finances and lifestyle can change.
Maybe you're seeing a new specialist. Maybe you're traveling more. Maybe your prescriptions have changed. Or perhaps nothing significant has changed and your existing coverage continues to fit you very well.
That's exactly what an annual review should help determine.
“A Medicare plan review isn't about changing plans. It's about knowing whether you should stay or change.” — Charise Karjala
My Medicare Rule of Four
After more than 20 years working in insurance, I encourage people to remember four things:
Doctors. Prescriptions. Financial exposure. Your life.
“Every annual Medicare review should answer four questions: Are my doctors accessible? Are my prescriptions covered appropriately? What is my total financial exposure? And does this coverage still fit my life?” — Charise Karjala
There isn't one Medicare strategy that's right for everybody.
The better question isn't simply, “Which plan looks best?”
It's:
“What will my health-care strategy look like when I actually need to use it?” — Charise Karjala
Review the numbers. Review the coverage. Ask questions. Then make an informed decision.
About Charise Karjala
Charise Karjala is a HealthMarkets Insurance Agent with more than 20 years of insurance experience, helping individuals understand Medicare and health insurance options throughout Southern California, Arizona and Nevada.
Educational information only. Medicare plan premiums, benefits, provider networks, formularies, cost sharing, maximum out-of-pocket limits and availability vary by plan and location and may change from year to year. Review official plan information before making enrollment decisions.
