Pick the Right Medicare Advantage Plan

By Marlo Sollitto, AgingCare.com contributing editor

An important Medicare deadline is approaching for seniors: The Medicare Annual Enrollment Period will begin October 15, 2011 and end December 7, 2011. This is a change from years past when the Annual Enrollment Period began November 15 and ended December 31. If you need to enroll in a Medicare Advantage or prescription drug, change an existing plan, move to a new one or dis-enroll now is the time to take action.

The Open Enrollment Period which ran from January 1 through March 31 was eliminated for 2011 plans and is no longer available.

These date changes are bound to catch many people off guard. Be proactive and compare plans as soon as possible.

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Steve Zaleznick, Senior Medicare Adviser of PlanPrescriber, a website that provides free comparison tools and educational materials for Medicare-related insurance, told AgingCare.com the challenge for Medicare beneficiaries and their advisors is to make a plan selection that fits their needs and is sufficiently flexible to cover any unknowns the upcoming year might bring.

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How to Pick the Right Medicare Advantage Plan originally appeared on AgingCare.com

Tips for choosing a Medicare Advantage Plan

For some seniors, it makes sense to consider a Medicare Advantage Plan. The premiums are usually lower than having traditional Medicare, a Medicare Supplement plan (such as Medigap) and a Part D drug plan. But the key is to understand your needs…and know what you are buying, Mr. Zaleznick says. Some things to consider during your decision making process:

What is Medicare Advantage? Medicare, the traditional benefit provided by the government, has gaps in coverage. There’s no cap on what a beneficiary could spend. For example, approximately of 20% of physician fees are paid by the beneficiary, Mr. Zaleznick says. A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.

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Know the difference between Medicare Advantage and Medicare Supplement plans. A Medicare supplement covers gaps in Medicare, but does not cover prescription drug costs. You would need to enroll in a separate Medicare drug plan to get that benefit. Medicare Supplement plans tend to provide more “first dollar” coverage when you require medical care. Because Medicare Advantage Plans often include a prescription plan, it can be a more encompassing coverage. Known as MAPD, Medicare Advantage Plans still have deductibles and co-payments, but the maximum that a beneficiary will pay out-pocket, other than for drugs, is capped at $6,700.

Look at out-of-pocket gap. Whether or not you need a Medicare Advantage Plan depends on how much out-of-pocket expense you are willing to take on. A good place to start is to analyze how much money you’ve spent on health coverage not covered by Medicare over the last few years, including the amount you’ve spent on the premium, co-pays and deductibles.

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How to Pick the Right Medicare Advantage Plan originally appeared on AgingCare.com


Make sure your preferred doctor is part of the network. If you want to use your doctor, check beforehand that he or she is an in-network provider for the Medicare Advantage Plan you are considering.

What You Can Do During Open Enrollment

Check your medications. Check all of your medications to see if they are covered or not. To check the medications you take, visit the Drug Cost Calculator tool on the Plan Prescriber’s website.

Consult local experts. Rates and benefits differ widely among plans and states. Talk to someone who knows the regulations and nuances in your state.

Check your plan yearly. Every year during the Annual Enrollment Period, revisit your choices from last year. Look at the financial cost and consider other options.

“An increasing number of Baby Boomers are now enrolling in Medicare for the first time. As they begin to understand the different types of Medicare coverage available, and the specific Medicare enrollment periods that correspond to each coverage type, the enrollment dates become even more important,” Mr. Zaleznick says. “Procrastination is not your friend. “Doing nothing is not the answer.”

Anyone struggling to select the right Medicare plan should contact Medicare 1-800-MEDICARE (1 800-633-4227) or a licensed PlanPrescriber agent at 800-404-6968.

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How to Pick the Right Medicare Advantage Plan originally appeared on AgingCare.com



David Lam
David Lam6 years ago

Great article!

june t.
june t6 years ago

My friends in the US find this to be a nightmare.

Donna Hamilton
Donna Hamilton6 years ago

Helpful info - thanks for posting.

Nancy Baird
Nancy B6 years ago

To Sue H - I'm a licensed insurance agent who works with both Medicare Supplement and Medicare Advantage plans. There are laws severely restricting what we can say about Medicare Advantage plans until we get a signed form from the individual permitting a meeting, which often must take place at least 48 hours later. Maybe that's why you weren't getting any good answers! It can be frustrating for all concerned.

Joe R.
Joe R6 years ago

Did our legislators know how hard this is for most of our elderly citizens? I've helped my Mom with this for years sorting through too many options. Having to repeat it year after year is painful as each plan keeps changing. Nice job congress! But then again, I'm sure your insurance company buddies are happy.

Jayne Braby Bethard

Thank-you for sharing this valuable information.

Valli Sarvani
Valli Sarvani6 years ago

Good info.

Becky S.
Becky S6 years ago

For anyone with questions about Medicare, and other health insurance issues, PLEASE consider contacting your local State Health Insurance assistance Program (SHIP). Every state has one! They are volunteer based, and do NOT sell or endorse any health insurance company (not do they make commissions or anything like that, which is how most "agents" work). SHIPs are there simply to make sure Medicare beneficiaries get the info. they need to make decisions. Counselors can also help youide which MA plan(s)are offered in your area and which one(s) best meet your needs.
Simply google "state health insurance assistance program" for your state and give it a try!! (in So. Cal the # is 1-800-434-0222)

Douglas S.
Douglas S6 years ago

Good to get this news out!

Rita B.
Rita B6 years ago

good info! thanks!