Growth in Medicare plans gives seniors even more decisions to make

Limiting their provider networks helps Medicare Advantage plans keep their premiums low. Traditional Medicare covers health care visits all across the country.

Seniors can begin shopping for Medicare coverage during the open enrollment period that starts Monday. Choosing the right plan can be complicated, and with more Medicare Advantage plans hitting the market this year, they have even more options to consider.

Basic Medicare coverage through the federal government doesn’t cover prescription drugs, eye care, dental visits, or hearing aids. Seniors have to buy that coverage separately, and there’s lots of different plans to choose from.

One way to get this coverage is through a Medicare Advantage plan; they’re sold by private insurers and often cover the benefits basic Medicare leaves out. And seniors have more of these plans to choose from for next year. According to the Centers for Medicare and Medicaid Services, insurers are offering a total of 3,700 Medicare Advantage plans next year, a 20 percent increase.

Companies such as Clover Health, which will offer plans in Philadelphia for the first time, are expanding into new markets. To get the word out, Clover is enlisting former Mayor Michael Nutter as a paid spokesman. Nutter penned a recent op-ed in the Philadelphia Inquirer arguing that not enough city residents are enrolled in Medicare Advantage plans, missing an opportunity to get more comprehensive and affordable coverage.

  • WHYY thanks our sponsors — become a WHYY sponsor

But Marilyn Burstin, an independent Medicare broker in Philadelphia, said there’s no one type of plan that’s right for everyone. While premiums for a Medicare Advantage plans are sometimes lower, members have to see doctors in the plan’s network to be covered.

“My own personal feeling is there’s no perfect plan if you can’t go see the doctor you’ve seen for the past 15 years,” she said.

Burstin was doling out advice at a senior expo in Port Richmond Friday put on by state Rep. John Taylor, R-Philadelphia.

Fifteen years happened to be exactly how long Rose Webster had been going to a health center covered by her Medicare Advantage plan. But now, the 76-year-old from Juniata Park said, the plan was dropping her health center from its network.

“They’re downsizing,” said Webster. She was looking for a new plan so she could continue going to the clinic. “I get my medicine there, I get my blood work there, I get everything there. I’m not dropping them.”

Limiting their provider networks helps Medicare Advantage plans keep their premiums low. Traditional Medicare, on the other hand, covers health care visits all across the country.

Burstin said seniors should also check whether a plan covers the prescriptions drugs they need, and consider whether they would take advantage of other benefits — such as gym memberships — these plans may offer. She said she welcomed the arrival of new Medicare Advantage plans, which means more options for seniors.

“Instead of having only one company to look at, you can have three or four,” she said.

Medicare beneficiaries have until Dec. 7 to weigh their options and enroll in a plan for next year.

WHYY is your source for fact-based, in-depth journalism and information. As a nonprofit organization, we rely on financial support from readers like you. Please give today.

Want a digest of WHYY’s programs, events & stories? Sign up for our weekly newsletter.

Together we can reach 100% of WHYY’s fiscal year goal