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Your Financial Future: Consider health care needs when choosing a Medicare plan

3 min read
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Open enrollment period for Medicare begins on Saturday, Oct. 15.

Along with political ads, every other ad on television these days is about choosing a health plan, and your mailbox is probably full of sales information. Every company claims to be your best choice. Many people get suggestions about their choices from friends and neighbors.

To find your best choice, you have to consider your own health situation. Probably the two most important considerations are who your doctors are and what medications you take. Every Medicare plan must offer doctors that practice every specialty. This means that there will be options for choices down the road. However, if you are already working with a doctor you trust and who understands your health conditions, you want to make sure your choice covers them.

Some plans offer a choice to every doctor who accepts Medicare. Others limit the new patients they accept who are on Medicare, so you may want to become a patient before going on Medicare. While this is an advantage, it may come with a higher cost.

Some policies come with a drug plan included and others require you to purchase a separate policy. Every plan can make changes from the year before. These changes can include which prescriptions are covered at what cost. This is known as the formulary. They contain different tiers of drugs at different prices. Generic are sometimes free. Often there is a second tier of preferred genetics. Name brands drugs have much higher prices.

Sometimes, the same drugs move to different tiers than the year before. I recently saw a price change for one drug that would cost $1,400 more this year than last year. This is why it is important to check these things every year. Once you start the new plan year on Jan. 1, the cost will be locked in for the rest of the year.

It is important to understand that most plans will have some out-of-pocket costs. There is also a donut hole for people with high prescription costs. During this time there are some reduced benefits. This was put into Medicare to try and help most people get some drug cost benefits, and people with more serious health conditions get more aid.

Some plans offer additional benefits such as eye care, dental and gym memberships. These Advantage plans often include drug coverage. Sometimes these policies are available at no cost. People often wonder how this can be possible. In Part C or Advantage plans, the government pays the insurance company to take over providing your insurance coverage. Current television ads highlight some benefits that most people do not receive such as increased Social Security benefits. Some of these extras might require that you be dual eligible, and because of your low income you might be covered by both Medicare and Medicaid.

To be on Medicare, you must pay a Part B premium that most people have taken out of the Social Security. The amount for next year will be announced later in October and take effect Jan. 1. Open enrollment ends on Dec. 7.

Review your options and make the best choice to try a minimize your out-of-pocket health care expenses.

Your Financial Future is written by certified financial planner Gary W. Boatman, MBA and CFP, who also wrote the book, “Your Financial Compass: Safe Passage Through The Turbulent Waters of Taxes, Income Planning and Market Volatility.” If there is an area that you would like to see discussed in the column, send your suggestions to gary@BoatmanWealthManagement.com.

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