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How to Comparison Shop for Medicare Coverage
Special to The Truth
If you are eligible for
Medicare, you should start exploring your options before you
need to select coverage. Many Medicare medical and
prescription drug coverage options are available for
comparison shopping.
There is much to compare,
particularly for health plans offered through private health
insurers, called Medicare Advantage (MA). These plans often
offer additional benefits -- like dental and vision coverage
-- as well as things like gym memberships, online doctor
visits and care coordination for people with certain chronic
conditions.
“Premiums and benefits are
different depending on the plan, so it’s important for
people to look at these differences to make sure their plans
meet their needs,” says David McNichols with Anthem Blue
Cross Blue Shield, which serves many MA members.
According to Mr. McNichols,
here are the basics when it comes to comparison shopping for
Medicare coverage.
Examine the plan’s list of
covered drugs. Different plans have different lists of
covered drugs, called formularies. Check to see if your
drugs are covered and at what cost, particularly if you’ve
gotten new prescriptions since you last picked your health
insurance plan. The drug coverage in Medicare -- called Part
D -- now includes more coverage for those with a “coverage
gap” and supplemental gap coverage is available in some
plans. The coverage gap is a temporary limit on what Part D
plans cover for prescription drugs. The gap starts after
both member and plan have paid a certain amount for covered
drugs. And different plans offer different benefits. For
example, in most of its plans, Anthem Blue Cross Blue Shield
offers drugs at a lower cost to those who use a pharmacy
network that Anthem Blue Cross Blue Shield recommends
because of its specially negotiated, lower drug costs.
Review the provider
network. Are your favorite hospitals, doctors and pharmacies
included in the network of your Medicare Advantage plan? You
should check, especially since, in some plans, costs
generally increase when you go outside the network. And in
other plans, to receive coverage you need to stick solely
with providers in that plan’s network.
Consider the extra costs.
When making your decision, weigh not only the plan’s monthly
premium, but other out-of-pocket costs, like copays,
coinsurance and annual out-of-pocket maximums.
Look for bells and
whistles. One of the pluses for Medicare Advantage plans is
the extras, such as gym memberships, nurse health lines,
online doctor visits, dental and vision coverage, and care
coordination for people with certain chronic conditions.
Compare plans to see what they offer.
Explore the possibility of
extra help. Those with limited income may qualify for
financial assistance. Ask your plan for more information.
Additionally, you can visit www.socialsecurity.gov/extrahelp
or call the Social Security Administration at 1-800-772-1213
(TTY 1-800-325-0778) for details.
To learn more, visit
www.Medicare.gov. You can also contact individual plans like
Anthem Blue Cross Blue Shield at www.anthem.com/shop or
(888) 900-4537 to learn about Medicare Advantage and other
options, including Medicare Supplement and Part D
prescription drug plans. Those needing help choosing a plan
may contact a State Health Insurance Assistance Programs
counselor by visiting https://shipnpr.shiptalk.org/shipprofile.aspx.
Anthem is a PPO plan, an
HMO plan and a PDP with a Medicare contract. Enrollment in
Anthem depends on contract renewal. For more information,
contact the plan. Limitations, copayments, and restrictions
may apply. Benefits, formulary, pharmacy network, provider
network, premium and/or co-payments/co-insurance may change
on January 1 of each year. You must continue to pay your
Medicare Part B premium.
This plan is available to
anyone who has both Medical Assistance from the State and
Medicare. Premiums, co-pays, co-insurance and deductibles
may vary based on the level of Extra Help you receive.
Please contact the plan for further details.
Courtesy StatePoint
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