Medicare Advantage plan shopping checklist
Published by
Michael Buttimer
on
Annual Enrollment Period (AEP) is a chance to make sure your health insurance still fits your needs. Before it begins, review your current coverage, identify the doctors and specialists you want to keep, check your prescriptions, and note the benefits you used most this year. Also consider any expected changes in your health, finances, or care needs.
Use this checklist to make sure the plan you choose still meets your healthcare needs, budget, and lifestyle.
Confirm your doctors and care team
☐ Do you have a PCP? Do you want to stay with them?
☐ Do you visit specialists?
Review your prescription medications
☐ Make a list of all medications you take regularly.
☐ Do you regularly take specialty medications or medications without a generic alternative?
Evaluate your healthcare usage
Think about the past year:
☐ How many times did you visit your PCP?
☐ How many specialist visits did you have?
☐ Did you have any hospital stays or emergency room visits?
☐ Do you expect your healthcare needs to increase, decrease, or stay the same next year?
Budget & Coverage Priorities
Think about your budget and coverage needs
☐ How much can you comfortably budget each month for health plan costs?
☐ Would you rather have lower monthly costs, even if you may pay more when you receive care?
☐ Would you prefer more predictable healthcare costs throughout the year, even if it means paying more each month?
☐ How important are extra benefits such as dental, vision, hearing, fitness programs, or over-the-counter allowances?
Review dental benefits
☐ Do you expect to need preventive dental care only?
☐ Do you anticipate needing crowns or other comprehensive dental services?
☐ Compare dental allowances and coverage levels between plans.
Review vision benefits
☐ Do you wear glasses or contact lenses?
☐ How often do you purchase eyewear?
☐ Compare vision allowances when evaluating your options.
Review extra benefits
Think about which benefits you are most likely to use:
☐ Over-the-counter (OTC) allowance
☐ Wellness benefits
☐ Transportation assistance for medical appointments and prescription pickup
If your current plan is changing
☐ Read your Annual Notice of Change (ANOC).
☐ Identify any benefits that are changing or being discontinued.
☐ Compare your current plan to other available options.
☐ Do not assume your current plan is still the best fit for your needs.
☐ Reach out for assistance if you are unsure about your options.
Ask yourself these three questions
1. What's most important to me?
☐ Lowest monthly premium
☐ Access to specific doctors
☐ Extra benefits such as dental, vision, OTC, or wellness
2. How much healthcare do I expect to use next year?
☐ Very little
☐ About the same as this year
☐ More than this year
3. Am I comfortable with the trade-offs?
Every Medicare Advantage plan balances:
- Monthly premium
- Cost-sharing when you receive care
- Supplemental benefits
- Financial protection
Make sure the plan you choose aligns with your priorities and expected healthcare needs.
Before you enroll
☐ Review all plan materials.
☐ Compare available plan options side by side.
☐ Confirm your providers and medications are covered.
☐ Estimate your expected healthcare costs.
☐ Contact a Medicare representative or licensed sales agent with any questions.
☐ Complete your enrollment before the AEP deadline.
Next steps
If you have questions, Massachusetts residents can receive free Medicare-related health insurance information, counseling, and support through the SHINE Program, and Mass General Brigham Health Plan offers a Medicare Basics guide.
To learn more about Medicare Advantage plans from Mass General Brigham Health Plan, please visit MGBAdvantage.org
Remember, the best plan is not always the one with the lowest premium or the most benefits. It is the one that fits your healthcare needs, budget, and priorities for the year ahead.
Mass General Brigham Health Plan is an HMO-POS organization with a Medicare contract. Enrollment in Mass General Brigham Health Plan depends on contract renewal. Our Medicare Advantage plans are available in Bristol, Essex, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester counties in Massachusetts.