Medicare Enrollment Tips from Professional Case Managers

9 Ways to Make Sure You Pick the Best Plan

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Oct 15, 2020, 15:39 ET

HAMPTON, Va., Oct. 15, 2020 /PRNewswire/ -- The professional case managers at Patient Advocate Foundation have a simple message during this Medicare open enrollment season, which runs October 15 - December 7, 2020: choose your plan carefully. It could save you thousands of dollars.

Erin Bradshaw, chief of mission delivery, has worked with countless Medicare beneficiaries and knows how often people get overwhelmed and rush the process. "Regardless of whether you are new to Medicare or already enrolled, taking your time during open enrollment to evaluate your needs and choose the correct plan could save you thousands of dollars."

One way to make the right choice? Ask questions. Health care is complicated, say the PAF case managers, so if you don't know what a term means, let alone what a plan really covers, ask questions until you find out all the information you need to decide. Other expert tips include:

1) Know the deadlines, and don't miss them. For instance, patients may not realize that they will face a penalty and be unable to enroll in Part B until the next open enrollment period if they miss the current one.

2) Have employer or retirement benefits? You may still need to enroll in Medicare. Many plans require people who are eligible for Medicare to enroll in a Medicare plan. If you are unsure, you should contact your benefit administrator – you may discover that your current plan will only cover 20 percent of your costs even if you don't enroll in Medicare

3) Know the difference between different types of Medicare plans - there may be one that is better for your needs. People often do not know the difference between Medicare Part A, B and Part D, let alone the difference between a MediGap plan, a Special Needs Plan and a Medicare Advantage plan. Open enrollment is the time to review the plan you have, compare it with other options and make sure your coverage will meet your needs for the coming year.

4) Look beyond your monthly premium. Your plan will inevitably require out-of-pocket spending beyond your monthly premium. Consider copay and coinsurance costs, along with potential out-of-network costs, particularly for Medicare Advantage plans.

5) Make sure you have a prescription drug plan. People may be unaware and unhappy that they must enroll and pay a separate premium for a drug coverage plan. When you choose a prescription drug plan, choose based on your current medications along with those you may need in the upcoming year.

6) New to Medicare? Consider a Medigap supplement plan. New enrollees have six months to enroll in a supplement plan without being subject to restrictions or increased costs based on pre-existing conditions. These plans cover copays, coinsurance and deductibles. You'll have to pay an additional monthly premium, but particularly if you have a critical condition, you may save thousands of dollars over the course of your plan.

7) Don't be fooled by advertising. PAF case managers report that many patients assume that Medicare Advantage plans—particularly those labeled "Complete"—will cover 100 percent of costs, even though they will only cover the same 80% of costs as traditional Medicare. Medicare Advantage plans may also impose a narrow network on beneficiaries, leaving patients subject to burdensome out-of-pocket costs if they see an out-of-network provider.

8) Review, review, review: Medicare plans, much like an employer-sponsored or Marketplace plan, can change their benefit structure annually. Even if your plan stays the same, your own medical needs may change. Review your coverage every year to make sure that you are enrolled in the best plan for your needs.

"People rarely have the opportunity to work with an expert to help them pick a plan. We're proud to offer assistance to qualifying people to make sure they make the right health and financial choices, whether it's through our direct case management services or through our library of educational resources that are open for everyone to use," said Bradshaw.

PAF provides educational material on its website, www.patientadvocate.org. People interested in simple tips on enrolling in Medicare may find these resources useful. And of course, the case managers have one last piece of advice:

9) Don't wait until the last minute! Choosing the right plan takes a lot of time, but with projected health care costs in retirement up to $390,000 for a couple on Medicare, you can't be too careful.

Patient Advocate Foundation is a national non-profit organization that provides free case management services to patients diagnosed with a chronic, debilitating or life-threatening condition. Case managers with expertise in insurance plan enrollment can help you review your options and narrow down the best plans to consider.

Media Contact:
Caitlin Donovan
Senior Director, Public Relations
(202) 465-5113
[email protected]

SOURCE Patient Advocate Foundation