What to look for when deciding on a Medicare health plan, from an expert

INDIANAPOLIS (WISH) – The Medicare Open Enrollment period started Oct. 15 and will continue through Dec. 7. For those who qualify but have not settled on a plan just yet, there are some questions you’re going to want to ask yourself before you decide on what’s best for you and your family. 

News 8 spoke with Ed Sandrick, director of the Veteran’s Channel at Humana, who offered his top tips on how to get the most of your 2021 Medicare health coverage.  

Gillis: The Medicare enrollment period has already started. How long is it open and what should people who qualify for Medicare do between now and when the enrollment period ends?

Sandrick: Yes, we’re in the midst of the enrollment period right now–the Annual Election Period–which began Oct. 15 and will end on Dec. 7. So there is still time for individuals to understand what their options are and to look at Medicare Advantage plans for 2021. 

I think at the top of the list of what could be a long checklist of items would be provider networks. Medicare Advantage plans typically operate through provider networks, so I think everyone should want to take a look at their primary care physician and specialty network to make sure your primary care physician or specialist is included in-network and the hospital where they admit to is also included.

Seniors, particularly those on Medicare, are typically on a fixed income and are taking a look at their budget and the cost of things. So, certainly the cost of the plan is an important consideration. The premium that you would pay monthly as well as the ongoing, out-of-pocket costs, including co-payments, co-insurance, deductibles … those sorts of things. Many seniors are on medications so the drug formularies that the Medicare plans offer is important. You want to make sure your drugs are included in the plan. 

And then the expenses overall. I recommend taking a look at what your overall expenses were this year and try to anticipate what they may be in 2021 so that the plan choices you make fit within your budget.

Gillis: I understand you work specifically with Humana’s veterans’ arm. What should veterans look for in terms of costs versus benefits before they decide on what plan is best for them?

Sandrick: Sure. Well, the indicators I just mentioned are important for everybody whether they are a veteran or not. But particularly those veterans who use the Veterans Affairs … they want to look for the very same thing. There are myths and misconceptions out there that if a veteran who uses the VA choses to enroll in Medicare or Medicare Advantage they would jeopardize their healthcare coverage. That’s simply not true. Medicare Advantage can complement what the VA offers. 

For the year 2021, for the second year in a row, Humana will be offering the Humana Honor Plan, which is a Medicare Advantage Plan with prescription drugs, again to compliment the VA healthcare. Typically most veterans who use the VA get their drugs at the VA. But the Honor Plan is available to anybody that’s eligible for Medicare. The Honor Plan has robust dental coverage, access to urgent care providers. It’s a zero-premium plan, and we are offering it in 46 states, and this year the Humana Honor Plan is recommended by USAA, as are all the Medicare Advantage plans offered by Humana. USAA, as you know is an outstanding service provider in the insurance industry for veterans and very well known for their customer satisfaction and commitment to veterans and their families. 

Gillis: Veterans don’t have to choose between VA benefits and Medicare health benefits. It doesn’t have to be one or the other, but they can be combined?

Sandrick: Yes. The veteran is essentially the quarterback of their care. When they are eligible for the VA or for Medicare Advantage, they can use the VA at the times when they need to or want to and they can also use the Medicare Advantage plan. They are entitled to both.

Gillis: And you recommend seeing a licensed agent if someone is inexperienced or if this is their first time going through this or it’s their first time qualifying.., seeing a licensed agent is best. How does someone go about doing that and where can people get more information?

Sandrick: I’ll start with your last question. They can get more information through the Medicare plan finder at Medicare does a great job of illustrating all of the available plans that are out there, especially in the zip code where an individual might live. Or call 1-800-MEDICARE and you can get the information that you need. 

With Humana, an individual can go to (our website) and see all the plans that are available to you in your area or you can talk to a licensed agent with a push of a button while you’re on the website or you can call our number and talk to a licensed agent.

Gillis:  Anything else you’d like to add? The deadline is coming around pretty quick. Should people get a move on this?

Sandrick: I think individuals need to take a breath. There is still time to consider all of the options that are out there. It’s important to research those options, and I think it’s very important for you to connect with a licensed agent so that he or she can understand what your healthcare needs are, what your financial situations are and what you can afford so they can guide you into the right plan. 

For more information about Humana Medicare Advantage plans, click here.

News 8’s medical reporter, Dr. Mary Elizabeth Gillis, D.Ed., is a classically trained medical physiologist and biobehavioral research scientist. She has been a health, medical and science reporter for over 5 years. Her work has been featured in national media outlets. You can follow her on Instagram @reportergillis and Facebook @DrMaryGillis.