How to Maximize Your Medicare Coverage During the Annual Election Period

Posted by Doreen Dann, RN, BSN, MHA
Estimated Reading Time 2 minutes 54 seconds

Medicare’s Annual Enrollment Period (AEP) is an important time for all beneficiaries. Whether you’re new to Medicare or have been enrolled for years, this window from October 15 to December 7 allows you to evaluate your current plan and make any necessary changes for the upcoming year. As healthcare needs and financial situations evolve, it’s crucial to ensure that your Medicare coverage still fits your needs.

Here’s how you can make the most of your Medicare coverage during the Annual Enrollment Period.

1. Review Your Current Plan

Start by taking a close look at your current Medicare plan. Whether you’re enrolled in Original Medicare, a Medicare Advantage plan, or have a standalone Part D plan, ask yourself these key questions:

• Are you happy with your current coverage?
• Have you experienced changes in your health or medication needs that your plan doesn’t fully cover?
• Are your costs, deductibles, and copays still within your budget?

Medicare plans can change from year to year, so the coverage or costs that worked well for you last year might not be the best option moving forward.

2. Evaluate Prescription Drug Coverage

Prescription drug costs are a major expense for many retirees, and Medicare Part D plans can vary significantly in terms of cost and coverage. During AEP, you can switch your Part D plan or join one if you didn’t have one previously.

To maximize your coverage, consider the following:

• Are your current prescriptions still covered under your plan’s formulary?
• Has the pricing for your medications changed?
• Are there new generics or alternative drugs that could lower your costs?

It’s also a good idea to use Medicare’s Plan Finder tool to review Part D plans and find one that offers the best coverage for your specific medications.

3. Check for Changes in Your Medicare Advantage Plan

If you’re enrolled in a Medicare Advantage (Part C) plan, take time to review any changes to your plan, provider networks, and costs for the coming year.

• Have your preferred doctors or specialists left the network?
• Have your out-of-pocket costs, such as copays and deductibles, increased?

Medicare Advantage plans can differ greatly in terms of coverage and flexibility, so switching to a plan that better suits your current health needs could maximize your budget and improve your access to care.

4. Consider Medigap Coverage

If you’re enrolled in Original Medicare and paying a lot out-of-pocket for deductibles and copays, it might be worth exploring Medigap (Medicare Supplement) policies. Medigap plans help cover expenses that Original Medicare doesn’t, offering more predictable costs and peace of mind. Although Medigap plans are not part of the Annual Enrollment Period (you can enroll or switch at other times), this is still a great time to review your overall coverage and consider how a Medigap plan could benefit you.

6. Take Advantage of Preventive Care

Medicare covers a range of preventive services, including annual wellness visits and screenings, at no cost to you. Make sure your current plan allows you to take full advantage of these services. Preventive care can catch potential health issues early, which can keep you healthier in the long run.

7. Ask for Help if You Need It

Navigating the different Medicare plans and options can be overwhelming. If you’re not sure where to start, or if your current coverage still fits your needs, don’t hesitate to reach out to a licensed insurance agent for help. Medicare’s AEP is your chance to make adjustments, but it’s important to feel confident in your choices.

Explore Your Options During Medicare’s Annual Enrollment

Maximizing your Medicare coverage requires careful consideration of your healthcare needs, financial situation, and any changes to your plan’s coverage. Don’t wait until it’s too late — use the Annual Enrollment Period to ensure you’re getting the most out of your coverage.

If you’re unsure about your options or need help reviewing your plan, call us an connect with a licensed insurance for more information. We can explain the various plans and help you to find the coverage that fits your needs for the year ahead!