What happens in a Medicare plan review, and what to have ready

Most people let their Medicare plan renew every year without checking it. A plan review is the hour you spend checking instead. It is a call, not an office visit: by phone or on video, whichever you prefer. It costs you nothing, and keeping the plan you have, now knowing why, is a perfectly good result.

Here is how one goes, so nothing about the call is a surprise.

Before the call

When you book, the confirmation email links to an intake form. It takes about 15 minutes, and with your doctors and prescriptions in it, your advisor can check them before the call. If you would rather do it on video, say so in the notes when you book and we will send a link. When you finish, your Scope of Appointment opens right after, about two more minutes. CMS requires a signed Scope of Appointment before we can talk with you about specific Medicare Advantage or Part D plans; it lists the kinds of plans you want to discuss. If you would rather not do either online, tell us, and we will go through them with you on the call.

Either way, gather four things:

• Your red, white, and blue Medicare card, and the card for the plan you have now
• Every prescription you take, with the dose and how often you take it. The bottles themselves are fine.
• The doctors you want to keep, and the hospital you would want to go to
• The Annual Notice of Change your plan mailed in September, if you still have it

That list is most of the work. The rest is ours.

The first part: what you have now

We start with the plan you are in and what it is changing for next year. Then we ask about how you use it: which doctors you see and how often, whether you travel, whether anything about your health has changed, and what you would want to be different.

There are no wrong answers, and you do not have to know plan vocabulary. "My copays went up and I don't know why" is a fine place to start.

The middle part: checking it against next year

This is the part that takes the time. For your current plan, and for any plan worth comparing it with, we check:

• Each doctor and the hospital, against next year's network
• Each drug, at your dose, against next year's drug list, including the tier and whether the plan wants approval before it pays
• Your pharmacy, and whether the same drugs cost less at a different one
• What a year would cost you, adding the premium to what you would pay for your drugs and your usual visits, not the premium alone

We can only show you plans from the companies we represent. We do not offer every plan available in your area, and if you want to see all of them, Medicare.gov and 1-800-MEDICARE can help with that.

The end: a decision, or no change

You leave the call with one of three answers. Keep what you have. Switch to a plan that fits better. Or take a few days to think it over, and call us back with your questions.

If you switch, we can do the application with you on the call. Joining a new Medicare Advantage plan ends the old one, so there is nothing to cancel, and the new plan starts January 1. A Medicare Supplement policy works differently: it does not end when you join an Advantage plan, so tell us if you have one before anything gets submitted.

What it costs

Nothing. The insurance companies pay us, and that payment is built into the plan's premium whether you use an advisor or not. Your premium is the same either way.

When to call

Changes have to be made by December 7, and the first week of December is the busiest week of our year. A review in November gives you time to think about what we find instead of deciding on the spot.

See what to check during Annual Enrollment, or book your review.