Choosing a Medicare Advantage Plan: What to Ask

medicare advantage, choosing a plan, questions to ask, Part D, open enrollment

Trying to choose a Medicare Advantage plan during the Medicare enrollment period? It’s important to know the right questions to ask.

This year, there are many more options available for Medicare Advantage plans. So it’s important to know you’re choosing the best plan for you. When asking questions regarding a specific plan, be sure to use the plan’s whole name, as plans can have similar names and differ in coverage. Let the doctor know about any health conditions you have, as these can affect your costs.

Before making the calls or researching online, make a list of your preferred doctors, as well as any prescriptions you take. This will save time and ensure you get the correct information you need.

Ask your doctor

  • Are you participating in this plan in 2019?
  • Are you accepting new patients in this plan? How soon can I schedule an appointment after January 1?
  • What would my copayment be for visits under this plan?
  • Will I need a referral to see you under this plan?

Ask your potential plan

  • Are my doctors in your network?
  • Does this plan offer additional benefits (transportation vouchers, meal delivery, in-home care)? If so, what are they, what’s their max dollar value, and what are their limitations?
  • Can I get reduced copays by using in-network doctors? Are there reduced copays for specific patients, like people with diabetes?
  • Will my health status or new diagnosis affect what I pay?

Ask your potential Part D drug plan

  • Does your Part D plan cover my prescriptions and any other medications I might need this year?
  • Is there preferred pricing at my local pharmacy?
  • How do you notify beneficiaries of changes in what drugs are covered?
  • How you do notify beneficiaries when generics are being substituted for brand-name drugs?

Medicare Advantage, questions to ask, choosing a plan

Open enrollment runs from October 15 – December 7. Take advantage of this opportunity to make changes to your Medicare coverage. Changes will go into effect January 1. 

In 2019, there’s a new Medicare Advantage open enrollment period, during which you can make a switch if you are unhappy with the plan you chose. From January 1 through March 31, you’ll be able to switch to a different Medicare Advantage plan or back to Original Medicare.


blog image

Medicare World Blog