Enrolling in Medicare or other plans? Experts say read the fine print

Medicare open enrollment is underway and it is also the time of year when other public health coverage programs and employer-sponsored plans carry out their sign-ups.

Wisconsinites are being encouraged to weigh their options. Advisers said reducing health care costs involves more than focusing on monthly premiums. You should also compare a plan's copays and deductibles.

Adam VanSpankeren, navigator program manager for Covering Wisconsin, which helps people understand and sign up for publicly available health insurance and similar programs, said reading notifications this time of year is vital because a small, subtle difference could end up being a big shock.

"You might be used to going to your doctor year after year, and then find out that they're actually not covered by your plan anymore," VanSpankeren explained. "That's got to be the most kind of disheartening and surprising thing. And people often discover that when they go to get care."

As for Medicare, original plans do not cover prescription drugs, so what's known as the Part D plan is needed for medications. Starting in 2025, the plan will include a $2,000 cap on what you pay out-of-pocket for prescription drugs covered by your plan.

Health policy analysts said there can be trade-offs when deciding between a traditional Medicare coverage option and a Medicare Advantage plan.

Dr. Rhonda Randall, chief medical officer and executive vice president of UnitedHealthcare Employer and Individual, noted Advantage plans tend to cost more, but are worth considering for the benefits they provide.

"Things like dental, vision and hearing," Randall outlined. "Many Medicare beneficiaries might be surprised to know that original Medicare doesn't cover most of those things, but many Medicare Advantage plans do. I also recommend people to check for mental health coverage."

About 56% of Wisconsinites signed up for Medicare have advantage plans. Program enrollment runs through Dec. 7. UnitedHealthcare offers an online guide for navigating Medicare. Meanwhile, people with employer-sponsored health plans are also entering their enrollment season and sign-up through the health insurance exchange under the Affordable Care Act begins Nov. 1.