The Importance of Annual Medicare Plan Reviews: Why You Shouldn’t Skip This Step

by Emerald Medicare | Aug 20, 2024 | Uncategorized

As your knowledgeable, compassionate, and trusted Medicare resource with Licensed Medicare experts, we know that your healthcare needs are unique and can change over time. That’s why it’s essential to review your Medicare plan options annually to ensure your current coverage still meets your health & budgetary needs. Even if your current plan served you well last year, changes in your health, plan benefits, industry changes, or costs could mean that a different plan is now a better fit for you.

Why an Annual Review is Essential

Changes in Health Needs
As the years pass, your healthcare needs may evolve. You or a family member might be dealing with a new health condition, which may require different medications, or the need to see a new doctor. Your current plan may not cover these needs as comprehensively as other plan options. An annual Medicare plan review allows you to adjust your coverage to meet any new health requirements.

Plan Changes
Medicare plans are not static; in fact, most Medicare plans change regularly. Carriers often change their coverage, provider networks, co-pays, deductibles, and/or drug formularies from year to year. For example, your current plan might increase premiums, adjust what services or ancillary benefits it covers, or drop certain healthcare providers from its network. Reviewing your plan annually ensures you’re not caught off guard by these changes and can switch to a plan that better suits your needs if needed.

New Plan Options
Each year, new Medicare plans become available and some are eliminated. A newer plan could offer better coverage or lower costs. For instance, a new Medicare Advantage plan in your area might include or reduce additional benefits like dental or vision coverage. By exploring these new options during the Annual Enrollment Period (October 15th – December 7th), you could find a plan that offers more value and better meets your needs to assure that you have no surprises heading into 2025.

Avoiding Penalties
Certain Medicare plan decision, such as Part B (outpatient medical services) and Part D prescription drug plans, have late enrollment penalties. If you’re not careful, you could end up paying more simply because you missed a deadline you were unaware of. When approaching age 65 or retirement taking the time to access a resource to conduct a thoughtful review of your specific situation helps you stay on top of these important deadlines and avoid these avoidable penalties.

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How to Conduct an Effective Annual Review

Evaluate Your Current Coverage

- - Start by reviewing what your current plan covers. Are there any gaps in coverage, or services you didn’t use? Are there services you’d like to add? No plan offers every service, but making a list of your current healthcare needs and the benefits you are looking for can help you determine which plan(s) best addresses them.

Compare Costs

- - Look at the total costs associated with your plan, including premiums, deductibles, co-pays, and out-of-pocket maximums. Compare these costs with other available plans to determine if you could save money by switching or staying the course with your current Medicare coverage decision.

Check Provider Networks

- - Ensure that your preferred doctors and healthcare providers are still in your plan’s network. If they’re not, you might want to consider switching to a plan that includes them to maintain continuity of care. Medigap plans have no network and include most doctors and facilities that accept Medicare. If you aren’t sure how to check which insurances your doctors accept, call the respective Medical office or seek assistance from your Medicare broker.

Consider Future Needs

- - Think about any upcoming health changes, procedures, or treatments that might require different coverage. Choose a plan that offers the flexibility to meet your future healthcare needs, such as increased prescription drug coverage, access to a specialist or a specific facility.

Medicare’s Annual Enrollment Period is Around The Corner

Each year on October 1, your ability to review you plan begins and continues until December 7th. An annual Medicare plan review is more than just a good practice—it’s the most important step in ensuring that you’re not overspending and you are properly covered. Don’t wait until it’s too late—start reviewing your Medicare plan with the experts at Emerald Medicare! Our team of Licensed Medicare professionals is here to help you navigate the review process and find the best plan for your budget and your health care needs.

Contact Us:
Phone: (888) 683-6372 or 845-358-1220
Email: office@emeraldmedicare.com

Click below to schedule an appointment with one of our Medicare Experts.

Mark Brownstein, CSA® - Calendly

Jackie Vogel - Calendly

7 Must Know Facts Regarding Dental Coverage

by Emerald Medicare | Aug 14, 2024 | Uncategorized

As your trusted Medicare resource, we understand the importance of all of your healthcare needs, which include dental care. In this post, we want to help you understand your Medicare Advantage dental benefits. Our goal is to empower you with the knowledge and tools you need to make informed decisions about your dental health within the framework of Medicare. Let’s dive into the world of dental wellness and Medicare together! Here are 7 must-know facts regarding dental coverage:

1. All Medicare Advantage plans do not have the same dental coverage, while 95% of MA plans offer some level of dental coverage.

While Medicare Advantage plans often include dental coverage, the extent of coverage can vary significantly between carriers & plans. While some may cover only basic preventive services like cleanings X-rays, or exams, others may also cover more comprehensive procedures such as fillings, crowns, root canals, or even extractions. It’s important for Medicare beneficiaries to carefully review the dental benefits offered by each Medicare plan or their company’s offering to ensure they meet their specific needs.

2. Standalone dental policies vary widely on details and cost.

Standalone dental insurance policies come in a variety of options, each with its own set of coverage details and costs. Some plans may have lower premiums + lower yearly out-of-pocket maximums for services, while others may offer more comprehensive coverage with higher premiums out-of-pocket costs for services, while others may offer more comprehensive coverage with higher premiums. It’s essential for individuals to compare the details of different dental policies to find one that best fits their dental needs & budget.

3. It’s OK to ask your dentist for a cash discount.

Many dental offices offer cash discounts for patients who pay for their services upfront or for those who are without dental insurance. Asking your dentist for a cash discount can help you save money on your dental bills, especially if you’re paying out-of-pocket for services not covered by insurance. Don’t hesitate to inquire about this option during your next dental visit.

4. Your dentist can be helpful in controlling expenses.

Dentists understand that dental care can be costly, and they’re often willing to work with patients to find cost-effective solutions. Whether it’s discussing treatment alternatives, offering payment plans/deferring services, or providing guidance on oral hygiene practices to prevent future dental issues, your dentist can be a valuable resource in controlling expenses while maintaining good oral health.

5. Expect to pay out-of-pocket beyond preventative services.

While many dental insurance plans cover preventive services like cleanings and exams at little to no cost, beneficiaries often fail to realize they might have to pay out-of-pocket for more extensive procedures such as fillings, root canals, or crowns. It’s important for individuals to budget for these expenses and explore options like dental savings plans or payment arrangements with their dentist to manage costs effectively.

6. After leaving a job, you might be able to keep your dental coverage through COBRA.

COBRA often allows individuals to continue their employer-sponsored health and dental coverage for a limited time after leaving a job. While COBRA coverage can be more expensive than what you paid as an employee, it provides a temporary solution for maintaining dental coverage until you find alternative insurance options.

7. Tax-free HSA money can help with out-of-pocket dental costs.

If you’ve contributed to a Health Savings Account, you can use your HSA as a tax-advantaged way to save and pay for qualified medical/dental expenses. Contributions to an HSA are tax-deductible, and withdrawals for eligible expenses – including dental care – are tax-free. Utilizing HSA funds can help offset out-of-pocket dental costs and provide financial flexibility for managing your oral health needs.