Medicare: A Recipe For SuccessMedicare
can be confusing. With the right
information, youll be ready to shop for a plan and choose the right one for
you and your needs. As you compare plans, benefits, and prices, its important
to keep a few key things in mind.
1. Many people take one or more medications on a regular basis. Review
the drug formulary to make sure the medication(s) you take are covered by the
plan.Make sure
to check:
Drug
brand names and generics
Prior
authorization requirements
Prescription
tiers and the associated costs
2. What may have been a great plan may not suit your needs anymore. Remember
to review your plan and coverage every year. Always keep your eyes out for:
Provider
and facility network: In-network versus out-of-network. Are your doctors
and facilities covered on your current plan?
Monthly
premiums: This is the monthly bill you pay for your coverage.
Out-of-pocket
(OOP) maximums: This is the total amount you may pay for services
covered each year.
Copays
and coinsurance: You may have copayments or coinsurances to pay for services.
Copays are fixed amounts, and coinsurance is usually a percentage of the
cost you pay.
Bonus perks: What options, tools, and
services are included on your plan? Find out about gym memberships, OTC
items, vision and dental, and other extras. Some perks may cost more.
3. Wading through the hundreds
of insurance companies can be downright exhausting. For starters, there are
several categories to consider:
Not-for-profit
vs. for-profit: Who is the priorityyou or shareholders? For-profit
companies must return profits to investors while not-for-profits must
reinvest their profits back into the plan to benefit members.
Customer
service you deserve: This is a big deal! Can you talk to a local person on
the phone? When you need answers, you need a real person to make things
happen for you.
4. The
Centers for Medicare and Medicaid Services (CMS) use a five-star quality rating
system. The Star Rating can tell you about a companys customer service,
member satisfaction, benefits, and overall quality. Companies receive an
updated rating annually, making it easy to weed out less than the best.
This article was submitted by Darin Vickery, Idaho-based Medicare
Sales Executive for SelectHealth. darin.vickery@selecthealth.org or
208-338-2019