Joining the right Medicare Advantage plan is one of the most important decisions you can make. And because a plan is only good for one calendar year, it’s one you will make time and time again.
Why is it then that so many people enroll in a Medicare Advantage plan with incomplete information? There’s more to an Advantage plan than whether or not the monthly premium is affordable and if your doctor is in the network.
Understanding all the components of the enrollment kit can help you compare plans and choose the best Medicare Advantage plan for your circumstances.. It’s important to look beyond the Plan Benefits Guide to ensure that you are choosing a plan that you can live with all year.
Medicare Advantage plan enrollment kit contents
Plan Benefits Guide: This is the high-level overview of the plan. This guide will detail the type of plan, any network restrictions and general information about co-pays and other cost sharing that will be required. Additional benefits beyond original Medicare and any optional riders are also highlighted. Think of this as the plan’s sales brochure.
Summary of Benefits: This booklet is an in-depth look at plan benefits and limitations. Also included in the Summary of Benefits is information about the member appeals and grievances process. To truly understand how your plan will benefit you and what your financial responsibilities will be look beyond the Plan Benefits Guide to the Summary of Benefits.
Medicare Advantage Explained: This informational piece is a good place to start if you are new to Medicare Advantage plans or have questions about how Advantage plans deliver benefits to their members. Types of plans are discussed as well as information about plans having the option to include Part D drug coverage. If you are considering Medicare Advantage enrollment this is good information.
Provider Directory: The Medicare Advantage provider directory can be one of the most important parts of your enrollment kit. This will include all types of medical providers for you plan. Provider directories are printed prior to October 1st, so it’s always a good idea to check with you provider to make sure that nothing has changed. Also consider that a provider may accept the plan and did not opt-in soon enough to be included in the directory.
Plan Formulary: The formulary is the list of medications that are included in an Advantage plan offering Part D coverage. Not all Advantage plans include Part D. If you don’t see a fornulary in your Medicare Advantage enrollment kit, there’s a good chance it is not included. If Part D is included it will also be referenced in the Summary of Benefits and in the Plan Benefits Guide.
Plan Contact Information: A separate sheet is included detailing the different methods of contact. It is important to keep this information handy in the event that you have a need to call customer service or if the company offers telephonic enrollment.
Compare Medicare Advantage plans by reviewing the enrollment kit
Understanding the enrollment kit is essential to choose the best Advantage plan for your needs. You may find yourself with enrollment kits from several different companies. All components listed above should be included.
Once you have several Medicare Advantage enrollment kits you may want to create a spread sheet and compare the different aspects of each plan in order to choose the best Advantage plan for you circumstances.
You can also go online to the Medicare website and get a high level view of plans that are available in your area. If you want to get more detail and compare all types of Medicare plans as well as process an enrollment you may find the eHealthInsurance website helpful.