How do I know if there are better Medicare options out there for me?

A fellow caregiver asked...

I am 73 years-old and already belong to AARP Medicare Complete from Secure Horizons. I am receiving various circulars and advertisements about Medicare and various plans, but find them all confusing and am wondering if any of them are any better than what I already have.

Expert Answer

Even if you are relatively satisfied with the Medicare Part C Medicare Advantage plan that you now have, at the end of each year (between November 15 and December 31) you may want to consider switching to a better plan -- or to traditional Medicare plus a Medigap supplemental insurance policy -- for the coming year. There are several reasons why you might want to consider changing coverage. If your Medicare Advantage plan drops out of coverage in the area where you lived, or if you move out of the area, you might be forced to consider alternatives. Or, your regular doctors, hospital, or other providers might be dropping out of your Medicare Advantage plan's network, in which case you may want to switch to a plan that still includes them.

Part of the reason you joined a particular plan may be the extra benefits it offered, but maybe those are now being cut. Or if your Medicare Advantage plan includes drug coverage, the plan may be changing its coverage for the worse -- dropping coverage altogether, or making it more expensive or difficult to get -- for one or more of the drugs you regularly take. In either case, you may want to switch to another plan that provides the extra benefits you want, or that has better coverage for your medicines. Also, your Medicare Advantage plan may be raising its monthly premiums, or its deductibles and co-payments, which will make your out-of-pocket costs go up substantially. Or even if none of these changes are happening, you may have heard about other plans that might be less expensive or cover more services.

Medicare Advantage plans vary from state to state, so to find out what plans are available to you, Medicare's official website provides an online service called the Medicare Plan Finder which gives you a list and contact information for all Medicare Advantage plans sold where you live.

Finding the plans is just the beginning of the process, though. Then you need to compare their coverage and costs. This includes finding out whether:

"¢ Your regular doctors and other providers are in the plan's network;

"¢ The plan pays anything for providers outside the network;

"¢ The drugs you regularly take are covered by the plan (if you choose a plan with drug coverage);

"¢ The plan covers services beyond what traditional Medicare covers;

"¢ The plan offers coverage when you're away from home, if you regularly travel out of your home geographic area; and

"¢ The cost and coverage combined is better than with traditional Medicare plus a Medigap supplemental insurance policy.

Making these comparisons takes some time and energy, but it may be well worth it. The article on this Caring.com site Open Enrollment: How to Switch Your Medicare Advantage (Part C) Plan for 2011 walks you through this process, helping you organize your paperwork and compare plans, using the information that the Medicare plan Finder provides.