10 Things To Ask Your Agent This Open Enrollment

October 15 to December 7 is that important time of year to look at your Medicare plan. This is the time when you can make changes to your Medicare coverage for the next year. Maybe you love your current Medicare Advantage plan and don't think you need to do a thing. But hold on! Your plan's benefits, costs, and network of doctors can change every single year. Your health needs may also be different. What worked for you last year might not be the best fit for you now. If you have a Medicare agent, it’s important to meet with them each year to ensure you continue to receive the best care for you. 

What to Talk About with Your Agent

Here are 10 key questions to ask to make sure you get the right Medicare Advantage plan:

1. Is my plan still being offered in 2026? This is the most important question to ask first. If your plan is no longer available, you'll need to find a new one.
2. Are there significant cost increases in my plan in 2026 like higher premiums? Even if your plan is still available, the costs might have gone up, and another plan could be more affordable.
3. Are my doctors in the plan's network? This is an important question. You want to make sure you can keep seeing the doctors you already know and trust.
4. Are all my prescriptions covered? Bring a list of all your medications. Your Agent can check if they are on the plan's official list of covered drugs (called a formulary) and how much they will cost you.
5. Could I be saving money on prescriptions with another plan? Your agent can help you compare plans and see if another option offers better coverage or lower costs for your specific medications.
6. What are the extra benefits? Medicare Advantage plans often include things that Original Medicare doesn't, like dental, vision, or gym memberships. Ask about what's included and how much value you are getting from these extras. Other plans may be offering more coverage.
7. What is the "out-of-pocket maximum"? This is the most you will have to pay for covered services in a year. 
8. PPO vs HMO - which one is right for me? Your agent can explain the differences between these types of plans and help you decide which one best fits your lifestyle and healthcare needs. PPO plans typically offer more flexibility, while HMO plans can be more restrictive. 
9. Do I need a referral to see a specialist? Find out if the plan requires a referral to see a specialist? Some plans require you to get a referral from your primary care doctor before you can see a specialist. At Clover Health, our HMO and PPO plans don’t require a referral.
10. Am I getting as much value as I could be? An agent can help you compare your current plan with other options in your area, ensuring you are getting the best coverage for your money. 

Taking the time to talk with your Medicare agent this AEP can save you a lot of money and give you peace of mind. You don't have to navigate these important decisions alone.

Discover a Medicare Advantage plan that goes beyond the basics. See what a Clover Health plan has to offer in:

• New Jersey

• Georgia

• Texas

• South Carolina

• Pennsylvania

With plans featuring $0 premiums, Part B givebacks, and valuable benefits like dental, vision, and a LiveHealthy Rewards program, it's time to find a plan that truly works for you.

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Looking for more Medicare tips? Explore our latest blogs for practical tips to make healthier choices and get the most from your Medicare benefits.  

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