4 Signs You Need a New Medicare Advantage Plan

There are certain costs you have to plan for as a retiree. And healthcare is a big one to factor into your retirement budget. Since it could easily take up a large chunk of your income, it's important to choose the right Medicare coverage.

Now when it comes to Medicare, you have choices. You could stick to original Medicare and buy a Part D drug plan on top of it. Or, you could sign up for an all-in-one Medicare Advantage plan.

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There are a number of reasons to choose a Medicare Advantage plan over original Medicare. For one thing, these plans commonly offer supplemental benefits beyond what original Medicare covers.

And unlike original Medicare, Medicare Advantage plans typically cap your costs with an out-of-pocket maximum. When you're on a fixed income that may consist largely of Social Security, that's an important thing.

But if your Medicare Advantage plan isn't the best one for you, you may be spending more money than necessary on healthcare, not to mention creating unnecessary aggravation. That's why it's so important to review your Medicare Advantage plan choices each year.

At this point, Medicare's fall open enrollment is underway. Between now and Dec. 7, you have an opportunity to make changes to your Medicare coverage. And that could mean finding yourself a new Medicare Advantage plan. Here are a few signs that you might need one.

1. Your costs are going up

There are different costs you might incur as a Medicare Advantage enrollee. Though some Advantage plans come with $0 premiums, that may not be the case with your plan. And on top of premiums, there are copays and potential deductibles to think about.

If your plan is getting more expensive in the new year but you're not getting extra benefits in return, that's reason enough to consider a new Medicare Advantage plan. Review your plan's annual notice of change, which you should have received by now, to see if that's the case. From there, you can compare your costs under different plans to see which one makes the most financial sense.

2. Your plan benefits are changing for the worse

It may be that your Medicare Advantage plan costs aren't rising, but that you're losing out on certain benefits that were part of your coverage this year. If so, that's another good reason to look for a new Advantage plan.

That said, when you review your plan options, make sure to focus on benefits that actually mean something to you. A fitness center benefit might seem like a great thing. But if you already have a walking group you meet with several times a week and you're unlikely to go to a gym, then there's no sense in prioritizing a benefit you may not get much use from.

3. Your preferred providers will no longer be in network

One drawback of Medicare Advantage plans, as opposed to original Medicare, is that they typically limit you to a specific network of providers. Going out of network could mean facing huge costs that drain your retirement savings.

If your preferred healthcare providers will no longer be in network come 2026, you may want to shop around for a different Advantage plan that allows you to continue seeing the doctors you're used to. This especially makes sense if you have certain specialists overseeing your care and you're nervous to have to start over.

4. Your health needs have recently changed

It may be that your Medicare Advantage plan isn't changing in the new year. But if your healthcare needs have changed recently, it pays to see if there's a better plan that meets your needs.

It may be that you've recently been diagnosed with a new condition. Or you may be taking or have plans to start a new medication. If a new Medicare Advantage plans offers better coverage given those personal changes, it could be worth making a change.

There's plenty of opportunity to switch your coverage

It's a good idea to consider a change to your Medicare Advantage plan if any of the factors above apply to you. But if you miss the boat during fall open enrollment, all isn't lost.

Medicare Advantage has its own open enrollment period from Jan. 1 through March 31 each year. During that time, you can switch from one Medicare Advantage plan to another if you so desire. You can even move off of Medicare Advantage and switch to original Medicare.

The key, either way, is to spend some time reviewing your choices. You won't know if there's a better Medicare Advantage plan out there until you look.

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