It might be tempting to choose the Medicare plan your spouse is on, but here's why individual is key

By Beth Newcomb

This year’s enrollment period for Medicare launches on Thursday, October 15, and ends on Monday, December 7. In theory this might seem like a lot of time to make sure the plan you’re enrolling in is the best fit for your needs, but in practice it really isn’t.

“The Medicare annual enrollment period is the time when everyone who has Medicare either continues into the next year with their current plan, or they decide to switch to a plan that better meets their changing needs,” says Marisella Rios-Weible, a licensed insurance agent with HealthMarkets Insurance Agency who shares the local agent-in-the-know spotlight with her daughter, Laura Weible, and seasoned pro George Halle. “They want to meet with a HealthMarkets agent to review where they are now, whether or not there have been changes to their current plan, and if switching to a different plan might better suit their needs in the coming year.”

With only so many hours available in the day, it’s important for you to schedule time to meet with a member of the HealthMarkets team in Parma or North Royalton now.

“It’s not a requirement to meet with one of us, but why wouldn’t you take advantage of our free guidance?” George asks. “We spend hours reviewing all of the changes to Medicare plans, so instead of having to dig through a pile of information trying to decide if your plan has changed for the better or worse, or if there is another plan out there that might be better suited to your current situation, you can sit down with one of us and have that answer in about 30 minutes or less. It’s the smartest half-hour investment you’ll make.”

The team at HealthMarkets has created a list of the three crucial areas to consider before enrolling in any Medicare plan.

Prescriptions
Perhaps the most important aspect to consider, taking a close look at which medications you’re taking, which medications you might need to start taking, or which medications you’re going to stop taking in the coming year is key.

Another thing to note is that the formulary list for the Medicare Advantage plan you’re on could be changing for the coming year. You’ll want to be certain your medications will still be covered and find out how much they’re going to cost.

Providers
“Provider lists tend to stay pretty stable from year to year,” Laura says.

“So, while it’s important to review, there aren’t likely to be any major changes. But what you might want to consider on the provider side of a Medicare plan is whether or not a specialist you’ll be seeing this year is on the list. For example, if you’re going to be getting cataract surgery, you’ll want to make sure the doctor performing the surgery is on the list. Or, if you’re going to be seeing a cardiologist, the same idea applies.”

Plan Design
“There are sweet spots to find in each plan and they differ from one to the next,” Marisella says.

The co-pay is another area that might vary from plan to plan, and you need to decide if that’s an expense that makes sense for your situation. Some plans don’t have a co-pay, but they might cost more. Northeast Ohio is fortunate to have a variety of plans, like Medical Mutual, available.

“There are a lot of variables,” George notes. “Some people need a plan with dental and vision built in, others might elect to pay for those separately. Reviewing the design of a plan is an important part of making your decision.”

Navigating the ANOC
Everyone currently on Medicare will get an Annual Notice of Change (ANOC). This important piece of information contains everything you need to know about what your Medicare plan will look like in the coming year, and if there are any changes. A free review with a licensed insurance agent from HealthMarkets can help you decipher exactly what this notice says and how it applies to you.

Their Guidance is Free
Because HealthMarkets agents aren’t captive, meaning they don’t work for a particular insurance carrier, they direct their efforts toward clients, helping them to navigate the sometimes-baffling waters of Medicare. And the cost for their one-on-one review and guidance? Nothing. All time spent with the HealthMarkets agent of your choice is absolutely free.

HealthMarkets is located 5925 Ridge Road, Suite 2, in Parma. A second office is in North Royalton, at 5740 Royalwood. Hours are Monday, Tuesday, Wednesday and Friday, 10 a.m.-5 p.m.; Thursday, 1 p.m.-5 p.m.; and Saturday, 10 a.m.-2 p.m. or by appointment. To get started with your free review, call one of the following agents: George Halle, 440-567-2271; Marisella Rios-Weible, 440-499-7840; Laura Weible, 440-263-3070.

HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and the District of Columbia. Not all agents are licensed to sell all products. Service and product availability varies by state. Agents may be compensated based on enrollment. No obligation to enroll. 46383-HM-1020