How to Prepare for Medicare Decisions

Editor's note: The following was submitted by Dr. Christopher Nguyen, a primary care physician at the Seal Beach Village Centers for Family Medicine.

Each fall, the patient questions come like clockwork. The concern is not about flu season or their illnesses, but about Medicare open enrollment.  It starts each year in October and continues through Dec. 7, with new benefits beginning in 2013.

As a physician, I can understand my patients’ confusion about Medicare.  It seems the issue of Medicare is on the minds of seniors as much as it is part of the current political dialogue.  The prospect of finding a new Medicare health plan or learning what medications are going to be covered in the new year can cause many of my patients more stress than any of their illnesses.

My patients save their Medicare questions for me as I am their primary care physician.  I direct their care and make sure they have access to the highest quality medical care and medications available under their health plan.  Over the years, I have offered my patients some tips to make the decision process a bit easier.

• Bring your doctor the materials you are getting in the mail about Medicare. Your doctor can help you sort out what your options are and how you can make better decisions based on your health care and medication needs.  It may be that your current coverage suits you perfectly or you may benefit from learning about other options that are available.
• Ask yourself if your health has changed.  Are you taking more or different medications now than last year? If so, there may be better Medicare health plan options for you. Do you suffer from a chronic illness? Again, there are special plans that may address this for you and provide improved quality of care and less out of pocket expenses.
• Consider cost and coverage.  Some Medicare Advantage Plans (Medicare Part D) cover much of your overall health care costs and some even have exceptional medication programs to suit your needs.  If you are happy with your current Medicare coverage, make sure that the benefits for 2013 are what you need and can afford.  Ask your doctor what health plans they like and how satisfied are their enrollees.
• Think about medications and other services.  Each year, the most significant changes in Medicare health plans may be the cost and choice of medications. Review your plan’s explanation of benefits or better yet, bring the materials to your doctor and together you can review what is best for you.

These are but a few of the issues that come to mind when I discuss Medicare with my patients and perhaps they can help you navigate the waters of your health plan options.