“Find a knowledgeable insurance agent,” says Joe Valenzuela, co-owner of Vista Mutual Insurance Services in the San Francisco Bay area. “Having an agent doesn’t cost the member anything. Medicare insurance agents are subject matter experts—many have spent years learning the ins and outs of each plan they represent. There are also many nuanced differences between Medicare Advantage plans. An agent can narrow down the search to only those plans that most closely align with the client’s needs.”
Pro Tip
Medicare beneficiaries with income over a set amount are required to pay a monthly fee in addition to their Medicare Part B and Part D premiums called an income-related monthly adjustment amount, or IRMAA.
Valenzuela recommends asking what is most important to a person’s needs when choosing a Medicare Advantage plan and keeping that priority top of mind. He also suggests paying attention to the fine print in the plan selected.
“Once you narrow your search down to one or two plans, look through the plan’s benefits line by line—you don’t want any surprises,” he says. “For example, a plan may have a low premium and copayments but might cost you much more each month in prescription copays.”
“A couple of important benefits to look at are the plan’s annual out-of-pocket maximum (the maximum amount the member could be responsible for in a calendar year) and your prescription drug costs,” adds Valenzuela. “Check all your medications on the plan’s formulary so you’re aware of the prescription copayments, deductibles and any restrictions.”
HealthCompare Insurance Services does not offer every plan available in a given area. Currently it represents 18 organizations, which offers 52,101 products in an area. Please contact Medicare.gov, 1-800-MEDICARE, or a local State Health Insurance Program (SHIP) to get information on all available options.
HealthCompare Insurance Services represents Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.