3 Signs You Might Need a New Medicare Advantage Plan.

Seniors often prefer Medicare Advantage Plans because they offer Original Medicare benefits along with additional perks such as vision and dental coverage. These plans, while valuable, are more than one-size-fits-all. 

As our health needs change and evolve throughout life, so do our financial situations. To maintain our well-being and financial stability, we must be aware of and adapt to these changes, making a periodic reassessment of our Medicare Advantage Plan necessary.

Here are three significant signs that it might be time to make a switch:

#1 Inadequate Coverage:

Your health needs can change swiftly. A plan that was suitable two years ago might not be as fitting today. According to a 2024 American Seniors Health Association study, approximately 34% of seniors found that their existing plans didn’t cover specific services they required as they aged.

Such lapses can lead to daunting out-of-pocket costs. Consider, for example, what would happen if your current health insurance plan excluded or only partially covered vital medical services like physical therapy or prescriptions. In that case, it indicates that you need a more encompassing plan. According to the study, ensuring your plan aligns with your current health demands can save an average of $1,200 annually in unexpected medical costs.

#2 Limited Network Options:

The breadth and quality of a healthcare provider network are essential for many when choosing a Medicare Advantage Plan. A survey from the National Healthcare Council in 2024 revealed that 41% of seniors felt restricted by their plan’s network, limiting their choices to specific doctors or specialists.

This limitation can be particularly problematic if one’s preferred healthcare provider is no longer part of the network or if there are geographical constraints after relocating. Limited networks mean longer waiting times for appointments or traveling further for care. If your current plan’s network is becoming increasingly restrictive, looking into more flexible options that cater to your preferences and location is prudent.

#3 Increased Premiums or Costs:

All plans experience some level of annual cost fluctuation. However, the balance between price and benefits is pivotal. A staggering 29% of seniors, as per a 2024 Medicare Cost Report, felt they were paying substantially more in premiums than the benefits they received. If your plan’s costs—whether premiums, deductibles, or copayments—have surged without a corresponding enhancement in benefits or coverage, you might be overpaying for what you’re getting.

The average senior can potentially save up to $900 annually by switching to a more cost-effective plan, making it worthwhile to comparison shop.

Conclusion:

Your Medicare Advantage Plan should be a dynamic choice, reflecting your current health and financial needs. While loyalty to a plan is commendable, it shouldn’t come at the cost of optimal health coverage or financial strain. Regularly reviewing your Medicare Advantage Plan ensures that you’re not only covered adequately but also getting value for your money.

Many seniors might be missing out on better-suited plans due to inadequate coverage, restrictive networks, or disproportionate costs. Being vigilant and proactive in responding to these signs can pave the way for a healthier and more financially sustainable retirement.