The Top 5 Mistakes to Avoid When Choosing a Medicare Advantage Plan

Happy senior couple hugging on walk near the lake during autumn day with Medicare Advantage Plan

Choosing the right Medicare Advantage plan is essential to ensure that you have access to the healthcare services and coverage you need. However, the process of selecting a plan can be complicated, and there are many common mistakes people make when choosing a plan. In this article, we will explore the top five Medicare mistakes to avoid when choosing one. By understanding these mistakes and taking steps to avoid them, you can find the Medicare Advantage plan that is the best fit for your unique needs and priorities.

Mistake 1: Not Considering All Options

You might think that choosing a Medicare Advantage plan over a Medicare Supplement was the only decision you’d have to make. Unfortunately, it’s not quite that simple! You’ll have several different kinds of Medicare Advantage plans to consider, some having more eligibility requirements than others. The five kinds of plans available include:

  1. Health Maintenance Organizations (HMO)
  2. Preferred Provider Organizations (PPO)
  3. Special Needs Plans (SNP)
  4. Private Fee-for-Service Plans (PFFS)
  5. Medicare Medical Savings Accounts (MSA)

Each type of plan has its own advantages and drawbacks. You’ll find lower out-of-pocket costs with an HMO, but you’ll also have more limitations with one. The opposite is true of PPO plans. We’ll discuss other things to consider in the next few sections, but for now, know that not all Medicare Advantage plans are the same.

Mistake 2: Not Looking at Provider Networks

No matter which type of Medicare Advantage plan you choose, one of the most important things to pay attention to is the provider network. For example, if you enroll in a plan with Company A, you’ll need to be sure to only see providers who are contracts with Company A. If you go to a non-contracted provider, you’ll have to pay more for services. Or worse, you may have no coverage at all.

If you are unwilling to change your current doctors, this should be an easy way to narrow down your selection. Check the plans provider directory to see which doctors are contracted before you enroll. You can also call your doctor’s office and ask which plans they accept.

It’s also important to note that provider networks can change from year to year, so you’ll need to check the directory every year during the Annual Election Period.

Mistake 3: Choosing a Plan Soley for Extra Benefits

Medicare Advantage plans have lots of bells and whistles, which is just one reason they’re so appealing. Most of them come with dental, vision, and hearing coverage, gym memberships, meal delivery services, over-the-counter stipends, and more. However, those extra benefits should not be the sole reason you choose a Medicare Advantage plan. It’s important to remember that those benefits might not be necessary or relevant to your individual healthcare needs. Those needs and priorities should be the primary focus of your decision-making process.

Instead, focus on the services provided by the plan, the deductible, and the coinsurance costs. How much will you pay when you see your primary care physician? What about a hospitalization or ambulance ride? A surgery? Those costs are more important than any of the added benefits.

Senior woman with her adult daughter walking at the park during during Annual Enrollment Period with Medicare Advantage
The reason AEP is important is that all Medicare Advantage plans operate on annual contracts.

Mistake 4: Ignoring the Annual Election Period

We hinted at this earlier, but the Annual Election Period simply cannot be ignored. AEP runs from October 15 through December 7 and is the time of year when Medicare beneficiaries can make changes to their current plans, including Medicare Advantage plans. You can enroll in Medicare Advantage for the first time, switch from one Medicare Advantage plan to another, or go back to Original Medicare.

The reason AEP is important is that all Medicare Advantage plans operate on annual contracts. They can change their benefits, networks, and fees each year. Plus, insurance companies are always trying to compete with one another. You may have an excellent plan now, but next year, a carrier might introduce one that fits your needs even better.

Any change you make during AEP will go into effect on January 1 of the upcoming year.

Mistake 5: Not Using an Independent Insurance Agent

Everything in Medicare can be made much more simple by using the help of an independent insurance agent. An advisor can provide valuable assistance in navigating the complex world of Medicare. These professionals are licensed insurance experts who can help you understand your Medicare options and select the plan that best meets your needs.

To work effectively with an advisor, start by being clear about your healthcare needs and priorities. This will help us understand what you are looking for and make appropriate recommendations tailored to your needs. The best part is that independent agents do not charge for their services. Our services are completely complimentary, and you won’t pay more in premiums because you used their services.

Ready to chat with a Medicare expert and avoid all these Medicare mistakes? Call Carolina Senior Benefits today!