Tips on how to pick the right Medicare Advantage plan

What’s the most important thing consumers should consider when choosing a health insurance plan?

Consumers should look at quality when considering a health insurance plan. Every year, Medicare evaluates plans based on a 5-star rating system. The rating system helps consumers assess Medicare health plan options for overall quality and performance — five stars means excellent performance. We’re honored that Sharp Health Plan earned an overall rating of 5 out of 5 stars from Medicare for 2022 and 2023. Sharp Health Plan is also the fastest-growing Medicare Advantage plan in San Diego and was named one of the Best Insurance Companies for Medicare Advantage in California in the 2023 U.S. News & World Report.

We recommend visiting Medicare’s official website to compare health and drug plans in your area. For free counseling about Medicare, Californians can contact the Health Insurance Counseling and Advocacy Program at 1-800-434-0222. Sharp Health Plan also offers free online seminars about how Medicare works and the benefits of Sharp Direct Advantage. Register for an upcoming free seminar to learn about your options.

Why should consumers re-evaluate their health coverage each year?

Open enrollment is an opportunity for everyone to evaluate what your current health plan covers, any costs to expect for services you need in the next year, and what matters most for your personal health and financial needs.

Review your health plan’s coverage documents to understand the services and costs covered by your plan. Think about which health care services you will likely need in the upcoming year. Have you or a loved one on your plan been recently diagnosed with a new health condition, intend to have surgery, or expect to start a new prescription drug next year? You’ll want to take that into consideration when deciding whether to keep your current plan or choose a new one.

How can consumers make sure to choose a health plan that covers all their prescriptions?

Finding the right prescription drug plan for you means doing your homework. The first step is to make a list of your must-have prescriptions. As you consider a health plan, look up each of your prescription medications in the plan’s drug list, also called a formulary, to make sure everything is covered. Generic medicines often cost less and may be listed in a plan’s drug list rather than brand-name prescription drugs, so be sure to include generic options in your search.

• Tip to save yourself money and worry: Compare Medicare health and drug plans with Medicare’s plan finder tool and use the option to enter your drugs for personalized cost information. It’s a good idea to do this early on during the open enrollment period.

Keep in mind that some prescription drugs have over-the-counter equivalents available for you to buy without a prescription, often at a lower price. Many Medicare Advantage plans offer an over-the-counter benefit to help with the cost of necessary health care items like cold medications, first aid supplies, dental care and more. For the 2023 coverage year, Sharp Health Plan’s VIP Plan features an over-the-counter benefit that provides members $100 every three months to purchase eligible over-the-counter items.