Prep for Medicare Open Enrollment: Top Questions to Ask Your Medicare Specialist

The recent pandemic has likely brought your healthcare to the front of your mind. These last months have brought up challenges and questions you may never have thought of before.

Even during the best of times, Medicare rules can feel confusing and you might be afraid that you will make a costly mistake. Medicare Open Enrollment is just four months away so if signing up for the first time or making a switch, here are the top questions you should ask a Medicare Specialist.

  1. Doctor and Hospital Choice
    You may be worried about whether you can continue to see your family doctor or which hospitals are in your plan’s network. You will need to ask:
  • Will I still be able to use my doctor?
  • If my doctor is sick or unavailable or I need to see a specialist in the future, how do I know they are in the plan’s networks?
  • Will I need a referral to see a specialist or new doctor?
  • If I need home health care or move to a skilled nursing facility which places are in your network?
  • How does my plan support telehealth visits? Will I have to pay a deductible for these appointments?
  1. Coverage
    If you need urgent medical attention, you will want to know you can be seen right away. Ask your Medicare Specialist:
  • Will my doctor require approval for me to be admitted to the hospital?
  • What areas are included in the plan?
  • Will I have coverage outside of this area?
  • Will I be covered for dental, vision and hearing care?
  • What tests are covered?
  • What rules and restrictions do I need to be aware of?
  • Can I have my prescriptions delivered? Am I covered for extra prescriptions if I need to have more on hand?
  1. Costs
    Out-of-pocket costs can quickly overwhelm you. Make sure and bring up these questions ahead of time:
  • What are the premiums, deductibles, and copayments that I will need to pay for my coverage?
  • What will I have to pay for prescription drugs? Are the prescriptions I need covered by my plan?
  • What about new or experimental treatments for diseases such as COVID-19?
  • How much will I pay if I see a provider out of my network?
  • Will there be a higher copay for care such as a hospital stay or home health care?
  1. Quality of Service
    It is important to choose a Health Plan that:
  • Understands your needs
  • Are experts in Medicare
  • Has a good reputation with positive reviews
  • Will provide you with quality service
  • Provides local resources with your interests in mind

Asking the key questions up front will give you peace of mind when Medicare Open Enrollment starts. It’s best to be prepared so there are no surprises.

At Inter Valley Health Plan, members always come first. Medicare Specialists are available to answer questions and help you navigate the complexities of Medicare health care. You can call 800-251-08191 or TTY 711, or email the Member Care Team to talk to a Medicare Specialist today.

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