10 Questions to Ask Before You Change Medicare Plans
Do you want to change your Medicare plan this year? It can be tempting to switch quickly, especially when there are so many choices during open enrollment. But if you make the wrong choice now, it could mean worse service, higher costs, or more problems later on. We at LMS Insurance Group know how hard it can be to figure out Medicare plans, and we are here to help you make the right choice.
We will show you the 10 most important things you need to think about before switching your Medicare plan. We will also show you some of the most common mistakes people make during open enrollment. Because you asked the right questions, you can pick a plan that meets all of your wants and will cover you for 2026.
Common Mistakes People Make When Changing Medicare Plans
Allow us to first talk about some mistakes we have seen people make during open enrollment. It is important to remember these things so that you do not slip up again.
Switching Plans for Flashy Benefits
It is easy to get excited about extra perks like OTC cards, food savings or flex cards. These added benefits are nice, but they should not be the only reason you switch plans. Even though such benefits sound great at first, they might cost you more in the long run if they come with extra costs like higher rates or co-pays. Check out a plan’s details by thinking about all of your healthcare wants, not just the extras.
Focusing Only on the Monthly Premium
People often make the mistake of moving to a $0 premium plan and thinking that it is the best choice. Even though the thought of a $0 fee sounds good, it is not always the best deal. A plan with a small annual fee, like $10, $15, or $20, can sometimes offer much better coverage and additional benefits. Do not let the fact that there is no extra make you decide. It is important to think about what the plan is worth in total, not just how much it costs.
Not Checking If Your Doctors Are Covered
This is one of the most serious mistakes we see. Your doctors may be covered by your current plan, but that does not mean they will be under your new plan as well. Always make sure that your chosen doctors, experts, and shops are in the network of your new plan before you switch. This is one of the easier ways to keep your care from being interrupted for no reason.
10 Important Questions to Ask Before You Change Medicare Plans
After going over some common mistakes, let us look at the 10 most important things you should think about before switching your Medicare plan. You can use these questions to figure out if the new plan really meets your needs.
1. Are my doctors and specialists covered in this new plan?
Before you make any changes, you should check to see if your present doctors are in the network of your new plan. You might have to pay more out of pocket or have to switch providers if your doctors are not covered. Before you switch plans, you should always make sure that your healthcare team is in the network.
2. Is my preferred hospital in-network?
If you need surgery or care in the hospital, make sure that the hospital of your choice is in the plan’s network. Medicare Advantage plans cover emergency care all over the country, but they may not cover treatments like joint replacements or surgery to fix cataracts if you do not go to an in-network hospital.
3. Does my plan have a prescription deductible? If so, do my prescriptions apply to the deductible?
Some Medicare plans have a prescription deductible, which is the amount you must pay for your medications before the plan starts covering the costs. If your plan has a deductible, you need to check if your prescriptions count toward it. Not all medications may apply to the deductible. You can find this information on medicare.gov, or a broker from LMS Insurance Group can help you compare plans and show you exactly how much your prescriptions will cost this year.
4. What is My Maximum Out-of-Pocket?
The maximum out-of-pocket is the most you could be required to pay for services in a year. For example, if you have a major medical event and need a lot of care, youâll want to know what your worst-case financial scenario is. The higher the maximum out-of-pocket limit, the more youâll pay if you need extensive medical care.
5. Does My Plan Require Prior Authorizations or Referrals?
Some Medicare plans, especially Medicare Advantage plans, need advance authorizations for certain treatments. This means that you need to get permission before you can get certain services. A lot of Medicare Advantage plans also need you to get a recommendation from your primary care doctor before you can see an expert.
Most of the time, you do not need recommendations or previous authorizations if you have a Medicare Supplement plan. Before you switch plans, make sure your new plan meets these needs so you do not get caught off guard.
6. How Will My Coverage Be Affected When I Travel?
It is important to know how your service works if you move a lot or live in another state part of the year. Most HMO plans have a small network, which means that you will not be paid for non-emergency services that are not in your plan’s network. PPO plans give you more choices, but care that is not covered by the plan may cost more.
7. What Are My Ancillary Benefits?
Dental, vision, and hearing are called ancillary benefits. Each plan has its own set of benefits, so it is important to check out what the new plan offers. If you buy dental, eye, and hearing care separately, it can get pricey, so if these are important to you, make sure they are included.
8. What Extra Benefits Are Offered?
In addition to basic health insurance, many plans give extras like rides to and from the doctor’s office, over-the-counter medicines, or even awards for doing fitness checks. Read over the extra features that come with each plan. They can make a big difference in how well you get care overall.
9. How Does This Plan Compare to My Current Plan?
It is important to look at a new Medicare plan side by side with your present one before moving. Why is the new plan better or more beneficial than the old one? Is the price the same or less? Extra benefits like food cards or over-the-counter (OTC) benefits may sound good, but make sure you compare the prices to see if they are better or worse than your present plan. By putting the two plans next to each other, you can see if the new plan really is a better deal or if it would be smarter to stick with the one you already have.
10. Can I Get a Side-by-Side Comparison?
Before you move to a new Medicare plan, you can and should ask for a side-by-side comparison. A good broker, like the ones at LMS Insurance Group, can do this for you and show you how your current plan compares to the new one. This will make the differences in price, coverage, and features very clear, so you can make an informed choice and avoid any shocks.
Tips for Open Enrollment of 2026
To help you make the most of this open enrollment, here are three tips we think you should know:
Use Medicare.gov to Compare Prescription Costs
Medicare.gov lets you see how much different plans cover your medications. This can help you find the most affordable option, so you do not pay too much for medicines.
Be Aware of Changes in Food Benefits
If youâre currently receiving a food benefit as part of your Medicare plan, keep in mind that this benefit might be going away in 2026 unless you have a chronic condition. Be sure to review the changes so you arenât caught off guard.
Do a Full Review of Your Plan
Medicare plans change every year. Even if your current plan worked well last year, itâs worth doing a full review to see if you can find a better deal or coverage for 2026. Working with a competitive broker can help you navigate these changes.
Conclusion
It is not enough to just pick the best Medicare plan; you also need to make sure that your health needs are met without going over budget. You can look over your plan and make sure you are getting the coverage you need during open enrollment. You can avoid the usual mistakes that many people make and make a better decision about your future health care if you ask the right questions.
Do not forget that the decisions you make today can affect your health and income for a long time. Do not make a choice right away; carefully consider all of your options. And LMS Insurance Group is here to help you every step of the way if you need it.
Are you ready to pick the best Medicare plan for you? Contact us immediately to set up a one-on-one meeting, and we will make sure you get the medicare coverage that meets your requirements and budget. Our team is here to help you through the process and feel confident as you go through Medicare. Contact us today to get started!
