Tips to navigate the Medicare Annual Enrollment Period

12:14 PM, Nov 20, 2017

The Medicare Annual Enrollment Period runs from Oct. 15 to Dec. 7, and in most cases is the one time of year where you can make changes to your Medicare coverage.

Even if you’re happy with your current Medicare plan now is the time to explore your options to see if you can save money and get more of what you’re looking for in 2018. Compiled below are tips to help you navigate the Medicare Annual Enrollment Period.

1. Identify your benefit needs

When considering what benefits you need, look back over the previous year to determine what benefits you selected. Also think about what care you may need in the upcoming year. This helps you review plans, as well as estimate your annual costs. Remember to consider your monthly premiums, deductibles, copays and prescription drug costs. Depending on your current health situation, you may want to reevaluate your current Medicare plan.

You should also note any updates that your health care provider has made to your current plan, as premiums, prescription coverage, and benefits may change from year to year.

2. Understand which plans are available

Original Medicare, offered by the federal government, is the most basic form of Medicare coverage and consists of Part A (hospital coverage) and Part B (medical coverage). Original Medicare covers around 80 percent of your medical expenses, and it does not include prescription coverage.

To help with what Original Medicare doesn’t cover, many choose to enroll in a Medicare Advantage or a Medigap plan for additional coverage. Both of these options are available through private insurance companies and have a monthly premium in addition to your Part B premium, although some Medicare Advantage plans have a $0 monthly premium.

Make sure you know the difference between these two options:

• Medicare Advantage plans offer everything Original Medicare does, plus more. Medicare Advantage plans tend to have lower premiums and offer a network of doctors. Some also offer out-of-network coverage, which can be beneficial if you travel or spend your winter in a warmer climate. Medicare Advantage plans also usually include prescription drug coverage. Most also include extras such as: dental coverage options, gym memberships, and services to help you manage your health.

• Medigap plans, also known as Medicare Supplement Insurance, work side-by-side with Original Medicare and help pay deductibles, coinsurance or copayments that Original Medicare doesn’t cover. With a Medigap plan, you can go to any doctor that participates with Medicare. But because these plans don’t include prescription drug coverage, you’ll need to purchase a separate Part D plan.

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Monthly premiums

With a Medicare Advantage plan, you may pay a lower premium, sometimes as low as $0 a month. Since most Medicare Advantage plans include prescription drug coverage (MAPD plans), you won’t need to purchase a Part D plan for prescription coverage.

Medigap plans generally have higher monthly premiums. Prescription coverage is also not included so you will need to purchase a Part D plan. But, due to the higher monthly premiums, your costs at the time of care, such as copays, are reduced.


With a Medicare Advantage plan, you receive “extras” such as a gym membership or at home fitness kits; dental, vision and hearing coverage options; medication reviews and more.

“Maximum out-of-pocket” amount

Medicare Advantage plans have a maximum amount members pay out of pocket for medical expenses. Different plans have different maximums, but once you spend that specific amount, the health insurer pays 100 percent of the services outlined as benefits in your plan. Most Medigap plans do not have a cap for the amount you’ll pay out-of-pocket per year.


Medicare Advantage plans are organized around a network of providers, often in a specific region or state. However, all Medicare Advantage plans include coverage for emergency and urgent care, including a hospital stay if you need to be admitted, no matter where you are in the United States. For other services, you will generally pay less if you go to an in-network provider, but many plans also offer out-of-network coverage options as well.

With a Medigap plan, you have the flexibility to see any provider who accepts Medicare throughout the United States.

4. Help is available when choosing a plan.

If you are confused about your Medicare plan options, there are a number of resources available to help evaluate plans and see which one may be right for you. has numerous guidelines and tips to help you choose which plan is the best fit for you. Priority Health is another resource if you need help choosing a Medicare plan. Call (866) 475-2901 to speak with a Medicare expert or visit to learn more about your Medicare options and discover why more individuals choose Priority Health Medicare Advantage plans over any other plan in Michigan*

Remember, even if you’re completely happy with your current plan, it is important to explore your options during the Annual Enrollment Period so you can make sure you have the right plan. You may be able to get more of what you need for less.

*According to January 2012-September 2017 monthly enrollment reports from the Centers for Medicare and Medicaid Services. Priority Health has HMO-POS and PPO plans with a Medicare contract. Enrollment in Priority Health Medicare depends on contract renewal.

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