Medicare Open Enrollment: 12 Tips to Get Great Coverage for 2021

Doctor counseling Medicare beneficiaries during open enrollment
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This story originally appeared on NewRetirement.

Tis the season… No, it is not quite time to decide whether you’ll say “Happy holidays,” “Merry Christmas,” “Bah humbug” or none of the above. It does, however, involve shopping: The fall Medicare open enrollment season is upon us and will last from Oct. 15 to Dec. 7.

Now is the time to assess your current coverage and shop around for perhaps a better deal or a plan more suitable to your current health needs. Here are 10 tips for getting the best coverage and care in the 2021 Medicare open enrollment period.

1. Know the open enrollment rules

Medicare
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Medicare’s open enrollment is a time period every year when you can:

  • Switch from Original Medicare to Medicare Advantage (or vice versa)
  • Change your Medicare Advantage plan
  • Join or switch to a different Medicare prescription drug plan

2. Find out how your existing plan has changed

A surprised senior couple looks at a document
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Not everyone knows this, but Medicare plans can — and do — change. So, the first step is to find out what is new with your existing coverage.

If there are changes, your plan should have sent you a “Plan Annual Notice of Change” (ANOC) in September. If you think you missed it, call your insurer and ask for the “annual notice of change.”

Pay particular attention to:

  • The list of drugs that the plan will cover in the next year
  • How much those drugs will cost
  • What the premium will be in 2021
  • What percentage the plan will pay for different types of medical expenses

3. Be aware of some of the global changes to Medicare Advantage

An older man talks to his doctor remotely on his laptop
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For cost cutting and other reasons, here are some of the bigger changes to plans:

  • Medicare will now allow patients to see nurse practitioners as their primary caregivers instead of doctors.
  • Telehealth services are on the rise, especially for dermatology, psychiatry, cardiology, primary care, gynecology and endocrinology.

4. Know that Medicare Advantage has expanded coverage

Seniors looking at laptop
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In 2017 there were 147 different counties — mostly rural areas — that completely lacked any Medicare Advantage insurers. According to the Kaiser Family Foundation, the situation has since improved.

Furthermore, for 2021 there are now a total of 4,800 Medicare Advantage plans available nationwide — another big increase, and the largest number of plans ever available.

5. Find out what plans your preferred doctors will accept in 2021

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You may want to call your doctors’ offices and ask to speak with the billing department. They should be able to tell you which plans they will be accepting in 2021. If they are dropping your existing plan, then you will want to see if any of the other plans are affordable for you.

6. Assess if your existing plan still is a good match for your needs

Older man looking at documents, with surprised expression,
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Once you know what your existing Medicare plan will cover in 2021, you should compare how well that matches your current and anticipated needs.

Will your existing plan still cover the medications you take? Has your health changed, and do you now have different needs?

7. Compare your existing plan to alternatives

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Even if your existing plan works well for you, you should still shop around to see if there is a more cost-effective option.

You can compare Medicare supplemental plans here. Or, you can contact your State Health Insurance Assistance Program (SHIP). SHIP provides free counseling to help people choose a Medicare plan.

Medicare also has a handbook, Medicare and You 2021, that will help you see what plans are available in your area.

8. Check out plan ratings

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Once you have identified a plan or plans that may be a good fit for your particular health needs, you can look up how well those plans are rated.

Medicare.gov lets you research plan quality and performance ratings.

U.S. News and World Report is also a reliable source. They evaluate all insurance companies and the plans they offer in each state. See the Best Medicare Advantage Plans and the Best Medicare Part D Plans.

9. Cut your prescription costs

Doctor with prescription drugs
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Even with supplemental coverage, prescription copays can add up. To save money, discuss your concerns with your doctor. Ask if they will prescribe a less-expensive alternative or a generic.

Whatever your doctor prescribes, shop around to fill your prescription. Filling the same prescription at Costco versus CVS could save a lot. Ordering a 90-day supply online may save you even more.

10. Use a health savings account (HSA)

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If you’re still working and are eligible to contribute to an HSA, take advantage of it. Your contributions are made pre-tax, the money in your account grows tax-free, and you can withdraw funds from the account at any time tax-free, as long as the money is used for qualified medical expenses.

Learn more about HSAs: what they are and why they are a compelling savings option.

11. Be proactive to stay healthy

Senior Woman Exercise
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If you are in good health, you’ll spend less on retirement health care costs.

Medicare offers a wide range of immunizations, preventive screenings and well-being programs for free.

12. Make sure out-of-pocket medical costs are factored into your overall retirement financial plan

Elder Couple w Adviser
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Out-of-pocket medical costs are one of the three biggest expenditures for most retirees. Studies have shown that the total out-of-pocket Medicare costs are higher than the total Social Security income for the average retiree. In other words, Social Security income does not even cover what most retirees will have to spend on their health.

So, it is important to make sure that your retirement finances are prepared for this major expense.

The NewRetirement Planner is an award-winning calculator that can help you prepare. This easy-to-use tool offers very detailed and sophisticated calculations and includes retirement health care costs.

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