Choosing a Medicare Plan

5 steps to selecting the plan that’s best for you

by Oraida Roman, President of Senior Products, Humana’s Nevada Operations

When selecting a Medicare plan, you have a wide variety of choices, so you’ll want to select the plan that best suits your needs. Here are five simple steps to help select the best Medicare plan for you.

Step One: Review your medical spending from 2007 and 2008

Give yourself a “healthcare audit.” Review your records and receipts to see how much you spent on health care. Don’t forget to include charges from physicians, hospitals and pharmacies – they all count. Many insurance companies provide annual summaries that track all your spending for you. You can also ask your doctor’s office or pharmacy for information.

Step Two: Identify future healthcare needs

While you don’t have a crystal ball that can predict what next year will bring, you can estimate what health care services you might need. Think about whether you have a condition that requires ongoing care, whether you need to stay on your current medications or if you need annual screenings. Talk to your doctor, too.
And, when you know all of this, use online resources such as the Family Health Budget (www.familyhealthbudget.com) to estimate your actual costs.

Step Three: Think about what you need from your Medicare plan

You’ve looked at what you spend, now think about other things, including cost, benefits, networks and convenience. Here are some things to consider:

• Cost — How much will you pay for premiums, deductibles and copayments? Plans with lower premiums may have higher out-of-pocket expenses (the amount you pay when receiving care, such as copayments, deductibles and coinsurance). The inverse is also true: if you’re paying a higher monthly premium, your out-of-pocket costs may be less.
• Benefits — Does the plan include all Medicare benefits in Part A and Part B? Does it also include prescription drug coverage? Is there supplemental coverage for the coverage gap? Do you need it?
• Doctor and hospital choice — Do the doctors, hospitals, pharmacies and other providers you use accept the plan?
  Are they conveniently located?

Step Four: Explore your options

There are many resources that can help you understand all the plan options available:

• State Health Insurance Assistance Program — The Nevada Medicare State Health Insurance Assistance Program (SHIP) gives free local health insurance counseling. Visit http://www.nvaging.net/ship/ship_main.htm or call 1-800-307-4444.
• Medicare – www.medicare.gov enables you to find and compare Medicare prescription drug plans and health plans in your area. You can also call 1-800-MEDICARE (1-800-633-4227).
• AHIP – www.healthdecisions.org/guide, a resource from the health insurance industry trade group America’s Health Insurance Plans, offers an easy-to-use, interactive online publication.

Once you understand the options that are available to you that fit your needs, you can visit the Web sites of the specific health plans and compare. Look at the things that are important to you and use tools like those available at www.humana-medicare.com/humana-medicare-drug-plan/medicare-rx.asp to compare plans, calculate prescription costs and learn about value-added wellness programs.

Step Five: Find out if you qualify for extra help

If you have limited income and resources, you may qualify for help paying for your Medicare health coverage. To find out if you qualify, contact your local Medicaid office or call the Social Security Administration at 1-800-772-1213. If you use a TYY, call 1-800-325-0778.

No matter which Medicare health plan you’ve chosen previously, you can switch to a different plan between November 15 and December 31. Or, if you are satisfied with your existing Medicare coverage and don’t need to make changes, you don’t have to do anything during the enrollment period. You will be automatically re-enrolled for the same plan for 2009.

As the fall approaches, use this time to make sound choices and get a full understanding of your options. After all, this is an important decision that you are committing to for an entire year. At the end of the day, few things are as important as your health and health care.
As you compare health care coverage, keep in mind:

• When considering prescription drug plans, take into account Medicare Advantage plans, including Special Needs Plans; as well as stand-alone prescription drug plans (Medicare Part D) and supplemental plans in which you may be qualified to enroll, such as Medigap.
• Check out special, additional services offered by health plans for Medicare members, such as gym memberships, and vision, hearing and dental coverage.
• Before selecting a plan, make sure you’ll have access to the physicians, hospitals and other health care providers/facilities that you are important to you.