You don’t need to make any changes to your supplement plan. Your benefits and coverage stay the same year after year. Read on for a quick review of what Open Enrollment means for you, and what you can ignore.
If you’re on a supplement plan, you don’t need to renew your plan or make any changes. Your benefits and coverage don’t change from year to year, so there’s nothing you need to do during Open Enrollment.
If you’re on an Advantage plan, it’s worth taking time to review. These plans can change coverage and costs annually, so confirm that you’re still getting the provider network and out-of-pocket costs you need going into next year.
It’s worth understanding what you’re really buying before making that decision. Medicare Advantage plans are private insurance alternatives to Medicare Part A and Part B. These plans are required to cover the equivalent of what Original Medicare covers – generally 80%.
What looks like savings up front may mean taking on significantly more financial risk and higher out-of-pocket costs when you need care most.
You still pay your Part B premium either way.
Supplement plans keep things simple. You can see any doctor or provider that accepts Medicare, anywhere in the country, without referrals or precertification. Claims are filed automatically, so you can focus on your health and the people you care about rather than paperwork.
Advantage plans require more attention. You’ll need to get precertification for certain medical procedures, review your claims records and verify that your medical provider is within network each year.
You can switch between different Advantage plans or move from a supplement plan to an Advantage plan during Open Enrollment. Going in the other direction is more limited.
If you choose Advantage when you first go onto Medicare, you have 12 months to switch to a supplement plan. If you switch to Advantage later, you have 12 months to move back to a supplement plan. After that, you must pass underwriting – a physical exam to assess your current health – to qualify for a supplement plan.
Always check whether your current Part D plan will meet your needs in the coming year. These plans can change their coverage and costs annually, so make sure your plan still covers your prescriptions at convenient pharmacies and at an affordable cost.
For information on reviewing your Part D plan or to receive assistance, please visit everence.com/part-d.
Medicare supplement plans work alongside Original Medicare to fill in the gaps not covered by Medicare. Medicare Advantage plans replace original Medicare and are required to cover the equivalent of what Original Medicare covers – generally 80%.
Be sure you understand what you’re getting and what you might be giving up before making any decisions.
| Difference | Medicare Supplement | Medicare Advantage |
|---|---|---|
| Coverage | Supplements Original Medicare | Only "equivalent to" Original Medicare (generally 80% coverage) |
| Cost | Additional monthly premium | Continue to pay Part B premium |
| Convenience | No networks, referrals, or prior authorizations. Portable. | Managed care plans |
| Choice | Ability to choose your doctor and healthcare facility | Must choose in-network doctors and facilities to avoid even higher costs |