Ready for open enrollment? 4 tips for choosing the right Medicare plan
With so many Medicare options available, selecting a plan can seem daunting. This year you may be wondering how news of Medicare drug price negotiations, economic uncertainties and other factors may impact your coverage in 2025.
Medicare is the government health insurance program for Americans 65 and older and others who qualify, providing hospital coverage (Part A) and physician visits (Part B) to beneficiaries. Additionally, there are a variety of options that coordinate with original Medicare, such as Medicare Supplement plans and Prescription Drug Plans, or replace original Medicare with Medicare Advantage (MA) plans combined with Prescription Drug Plans.
During this year’s Medicare Annual Enrollment Period (AEP), which takes place between Oct. 15-Dec. 7, 2024, here’s what Cigna Healthcare, which serves millions of Medicare customers nationwide, wants you to know:
1. Check for plan changes: If your current plan is working for you, you can likely keep it. However, it’s a good idea to review your plan every AEP, especially if you’ve experienced major life, health or financial changes. Any changes to your current plan will be outlined in your Medicare plan’s Annual Notice of Change (ANOC) letter, which you can expect to receive in September.
2. Research your coverage: There are a few key things to watch for when shopping for a plan. One of them is whether your favorite providers and specialists will be in-network. You should also review each plan’s formulary – that is, the list of drugs covered under the plan. You’ll want to find a plan that will cover your current medications and any you anticipate your doctor prescribing over the course of the year ahead. Finally, carefully consider your total spend for your prescription drug plan coverage (i.e., premiums plus pharmacy costs) since the maximum out-of-pocket costs for drugs you utilize will be capped at $2,000 in 2025.
3. Look for value: No matter what the economic outlook is, it’s wise to select a plan that provides great value. To that end, you may want to consider an MA plan, which offers quality and affordability. MA plans cover everything original Medicare does, plus more; most also include dental, vision and hearing benefits, prescription drug coverage, and other extras like over-the-counter drugs, transportation to doctor’s visits and pharmacies, healthy grocery purchases, and fitness services. MA plans are often available with $0 premiums, but you’ll also want to check on what your annual out-of-pocket costs could be based on your health status.
4. Understand your plan: Before enrolling in a particular plan, make sure you understand its ins and outs. Call Medicare at 1-800-MEDICARE (1-800-633-4227) 24/7; TTY users can call 1-877-486-2048. Or, visit the Medicare Plan Finder website at Medicare.gov/plan-compare. For local assistance, refer to the State Health Insurance Assistance Program at www.shiptacenter.org. You can also contact individual Medicare plans, including Cigna Healthcare at CignaMedicareInformation.com.
“AEP is your opportunity to assess your budget and your health needs and find an option that will work for you and your lifestyle in 2025,” says Ryan Kocher, chief growth officer for Cigna Healthcare Medicare. (StatePoint)