How to Review Medicare Plans During AEP

Posted by Doreen Dann, RN, BSN, MHA
Estimated Reading Time 1 minute 31 seconds

The Medicare Annual Election Period (AEP), from October 15 to December 7 each year, offers Medicare beneficiaries the opportunity to review, change, or enroll in a Medicare Advantage plan for the upcoming year. With various plans available, each offering different coverages, costs, and coverage networks, finding the right plan for your needs requires careful review.  Here’s how to evaluate Medicare Advantage plans to ensure you’re choosing the best fit for your healthcare needs.

Examine Plan Coverage

Medicare Advantage plans (also known as Part C) cover all services included in Original Medicare, plus prescription drug plan.  When reviewing plans, think about your specific healthcare needs.  Look for plans that may maximize your healthcare needs.

Review Costs Carefully

Consider each plan’s costs, deductibles, and copays. Medicare Advantage plans may vary. However, you’ll also want to look at out-of-pocket costs for doctor visits, specialists, hospital stays, and any other regular care you receive. Be sure to check the plan’s out-of-pocket maximum, as this is the highest amount you’d pay for covered care within the year.

Review Network Options

Each Medicare Advantage plan has its own provider network, meaning certain doctors, specialists, and hospitals will be considered “in-network” for that plan. Staying within this network typically lowers your costs, while going out of network may increase them. If you have preferred providers or specialists, make sure they’re in the plan’s network. PPO plans offer out-of-network options, but at a higher cost.

Evaluate Prescription Drug Coverage

Many Medicare Advantage plans include Part D prescription drug coverage. Review each plan’s drug formulary to ensure it covers your medications at an affordable price. Drug tiers, copays, and preferred pharmacies can vary, so choose a plan that helps keep your medication costs manageable.

Making the Right Choice

Reviewing Medicare Advantage plans during AEP can feel complex, but choosing a plan that aligns with your healthcare needs and budget is well worth the effort. Contact us today and speak with a licensed insurance agent to schedule a free plan review—we’re here to help you evaluate your options and find the best Medicare Advantage plan for your needs.