Your Money, Your Future
Your Money, Your Future

With Medicare enrollment winding down, most retirees don't shop around

Key Points
  • Older adults are more likely to compare costs for groceries (54 percent) than Medicare plans (33 percent).
  • Costs and coverage can vary among plans, meaning a better option could exist.
  • Fall open enrollment is the time to make changes related to Part C (Advantage Plan) and Part D (prescription drug coverage).
Getty Images | Universal Images Group Editorial

Just because retirees worry about their health care costs doesn't mean they're inclined to comparison shop for Medicare plans.

While a new survey shows that medical expenses rank as the most burdensome budget item for older Americans, they are more likely to compare costs for groceries (54 percent), homeowners/auto insurance (45 percent) or gas (44 percent) than their Medicare plan (33 percent).

"I think many people are wary of making big decisions about their health care coverage. It can be a scary thing to do," said Bart Astor, author of "AARP Roadmap for the Rest of Your Life" and a spokesman for WellCare Health Plans, which published the study.

"It's not always about the money," Astor said.

Source: WellCare Health Plans

The survey also showed that 23 percent of respondents say reviewing their Medicare plan is among the top two most unpleasant things they do, even though the survey's response options included getting a colonoscopy (84 percent) and going to the dentist (50 percent), doing taxes (29 percent) and renewing their driver's license (14 percent).

For most Medicare recipients, the once-a-year time to shift coverage is now. Open enrollment, the seven-week window when you can make changes related to Medicare Part C (known as an Advantage Plan) and Part D (prescription drug coverage), ends Dec. 7.

During this time, you can:

  • Switch from Medicare Parts A and B (original Medicare) to an Advantage Plan
  • Switch from an Advantage Plan to Parts A and B
  • Change your existing Advantage Plan
  • Change your Part D prescription drug plan

Despite being given a yearly opportunity to switch coverage, 62 percent of older Americans don't review their Medicare plan annually to make sure they're getting the best deal, according to the WellCare survey.

"It's confusing and more consequential," Astor said. "You're locked in for a year."

Source: WellCare Health Plans

Yet research suggest that if you live in an area where you have more than one plan option, it can be well worth your while.

For instance, when it comes to prescription drug coverage, there can be a huge disparity among providers in the price charged to plan participants. Examining one ZIP code, the Senior Citizens League found the average difference between high and low prices of the top 10 most-prescribed drugs was $593.

Whether you pick an Advantage plan that includes prescription drug coverage (most do) or choosing a standalone drug plan, also make sure the participating pharmacy meets your preference.

Additionally, it's important to check that your doctor or other important provider is part of any new plan. If you choose an Advantage plan that is an HMO and your doctor is out-of-network, your plan will provide no coverage. If you choose one that is a PPO, you can go out of network, typically with a higher cost to you.

More health care workers needed

While a plan's monthly premium is a big consideration for many consumers, it's also something that can backfire. Generally speaking, a plan with a low (or no) premium will find a way to make up the coverage cost elsewhere, either in higher deductibles or co-insurance, or even lack of coverage in areas you need.

For instance, if your health changes — maybe you accept that you really need glasses — and you do not have vision coverage, you'll have to pay out of pocket for all associated expenses.

"At the Medicare age, you're susceptible to conditions changing," Astor said. "I'm talking about not seeing well, tripping and falling, or even now getting classified as having hypertension when you didn't before."

(Note: On Monday, two health organizations changed the guidelines for defining high blood pressure to a reading of 130/80 from 140/90.)

Of course, if you're happy with your Medicare plan, you don't need to take any action. However, if you don't shop around, you won't know whether there's a better option.

"You may decide you still like your plan, but unless you start to look at your options, you don't know if it's the best one for you," Astor said.

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