Cut Medicare clutter this fall

If you’re on a Supplement plan, you don’t need to do anything. Your benefits, deductibles and copays don’t change annually, so you’re set.

If you’re on an Advantage plan, shop around. Your plan changes every year, so check you’re getting the coverage and provider network you need with out-of-pocket costs you can afford next year.

Know what you're buying before you jump. These are private insurance alternatives to Medicare Part A and Part B, with possibly some extras. You still pay your Part B premium. 

They are stripped-down plans offering the least coverage, which means you take on the greatest financial risk and have the highest out-of-pocket costs among all plan choices.

You pay a higher premium for a Supplement plan than Advantage plan. For that higher premium, you have minimal out-of-pocket costs and minimal financial risk.

You pay a lower premium for an Advantage plan, but it has higher out-of-pocket costs. It comes with a more substantial financial risk, since you're responsible for costs up to your plan’s “maximum out-of-pocket limit.” 

Supplement plans are simple. You can go to any doctor or provider that accepts Medicare, with no precertification or referrals. There’s no paperwork since medical claims are filed automatically.  

Advantage plans require attention. You pre-certify certain medical procedures, review your claims records and verify that your medical provider is within network. 

You can switch between different Advantage plans or move from a Supplement to an Advantage plan during open enrollment. Going the other direction is more limited. 

If you choose Advantage when you go onto Medicare, you have six months to switch to a Supplement plan. If you switch later to Advantage, you have 12 months to move back to a Supplement plan. After that, you must pass underwriting (to verify good health) to get a Supplement plan. 

Check if your current Part D plan will meet your needs next year. These plans can change coverage and costs annually.

If your drug plan is within an Advantage plan – or is a stand-alone plan – always make sure your plan next year still covers your prescriptions at convenient pharmacies and at an affordable cost. Learn more at everence.com/part-d.