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Medicare Advantage Plan Enrollment Tips

A successful Medicare Advantage plan enrollment begins with knowledgeRating Sheet and red Pencil

When it comes to your health nothing is more important than choosing the right health plan.

With a limited opportunity to change plans it’s critically important that you understand the ins and outs of the Medicare Advantage plan enrollment process.

When and how to enroll, what resources to utilize and how to recognize an unscrupulous sales agent all play into making sure you choose the best Medicare Advantage plan for your needs.

Advantage Plan – three enrollment tips

1. Understand the when and how of the enrollment period – The following year’s Medicare Advantage plans will be available to view on the Medicare website on October 1st. This is the same day that Advantage plan sponsors can begin marketing their plans.

You will not be able to submit an application until October 15th. The Annual Enrollment Period for plans with a January effective date begins on October 15th and ends at midnight on December 7th. You can submit an enrollment application:

  • Online
  • Over the telephone
  • Face to face with an agent
  • Through the mail

Start comparing plans early. Previously the enrollment period didn’t begin until November 15 while the date for marketing stayed the same. You had six full weeks to compare plan prior to enrollment. Now you have two weeks.

If you enroll in a plan and change your mind prior to the enrollment period ending… submit another application. The last application received will be the one that becomes effective January 1. No need to notify the first company as CMS does that for you.

Special Enrollment Period Allows you to Enroll Any Time in a Five Star Medicare Plan

2. Dig deep into these three plan documents … Don’t fall for a plan merely because of the premium or strong name recognition due to the saturation of advertising messages. Here are the most important plan documents to compare.

  • The Summary of Benefits – This document includes all the detail on what services are covered and what cost sharing amounts (copays, coinsurance and deductibles) will be required. This is generally a several page booklet or PDF. Don’t confuse this with a top view outline of coverage which generally consists of one page.
  • The plan’s Provider Directory – Be sure that your providers are in-network. Take the time to see which facilities are in-network as well. You will feel more pain (financially and as a lack of freedom) if a hospital or other ancillary facility is not in network than having a doctor not in network.
  • The Part D Formulary – There are more plans with Part D included than not. The formulary is the list of drugs which are covered by the plan and information about which tier a drug is listed in as well. If your drugs are not covered a low premium will not compensate.The Part D formulary is key to choosing the right plan.

3. Know the marketing guidelines – There will always be bad apples and some sales agent who rely on a commission believe that the annual Enrollment is open season on seniors. Here are some activities that an agent cannot engage in:

  • Make a presentation without a signed Scope of Appointment form.
  • Accept an application prior to October 15.
  • Cold call you.
  • Visit you unannounced at your home.
  • Approach you in common areas such as a parking lot or waiting room.
  • Offer you a gift or inducement to sign up.
  • Serve you a full meal at a Medicare meeting.

If you encounter any of these activities it’s probable that if you sign up you will not receive the customer service you deserve from an agent and may not have all the details about the proposed plan.

Follow these Medicare Advantage 2013 enrollment tips and you should be able to choose the right plan for your needs. Learn more about plan choices by visiting the Medicare website.

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