Medicare Benefits Review: 5 Steps for Choosing the Right Plan

Why a Medicare Benefits Review Matters

A Medicare benefits review is one of the most important steps adults turning 65 can take to protect their health and finances. With dozens of plan options, varying costs, and shifting enrollment deadlines, it’s easy to feel overwhelmed. That’s why a structured, personalized review can help you understand your choices and select a Medicare plan with confidence.

Whether you’re enrolling for the first time, reassessing during open enrollment, or supporting a loved one, these five essential steps will simplify the process and set you up for success.

Additionally, the Medicare landscape is always evolving—new carriers enter the market, plan premiums change, and coverage rules get updated. Conducting an annual review ensures that you’re not missing out on better coverage or potential savings.

Step 1: Understand the Parts of Medicare

Before diving into your Medicare benefits review, it’s critical to understand how Medicare is structured. The program is divided into four key parts:

• Part A: Hospital insurance (usually no premium)
• Part B: Medical insurance (doctor visits, outpatient care)
• Part C (Medicare Advantage): A private plan that bundles Parts A and B, often including Part D and extra benefits
• Part D: Prescription drug coverage

Each part has specific costs, coverage rules, and eligibility requirements. Knowing how these parts work together will help you compare options effectively during your review.

For an overview directly from Medicare, visit Medicare.gov – Get Started.

Understanding each part allows you to assess your current health needs and predict future ones. For example, if you anticipate increased medical visits or require a specialist network, your choices may differ from someone who rarely sees a doctor.

Step 2: Know Your Enrollment Windows

Timing is everything. Your Initial Enrollment Period (IEP) begins three months before you turn 65 and lasts for seven months total. If you miss this window, you could face penalties or delays in coverage.

A thorough Medicare benefits review ensures you:

• Understand when to enroll
• Avoid late enrollment penalties
• Prepare for future events like retirement or plan changes

You’ll also want to revisit your options each year during Open Enrollment (October 15 – December 7), when you can switch Medicare Advantage or Part D plans.

There are also Special Enrollment Periods (SEPs) for individuals experiencing certain life changes—such as losing employer coverage, moving to a new service area, or qualifying for Medicaid. Knowing if you qualify can allow you to adjust coverage when needed.

Step 3: Compare Plan Types and Costs

This is where your Medicare benefits review becomes most valuable. You’ll compare:

• Original Medicare (Parts A and B)
• Medicare Advantage (Part C)
• Medicare Supplement plans (Medigap)

Plan selection should take into account more than just monthly premiums. Look at total cost of care, including deductibles, copays, coinsurance, and out-of-network charges. You’ll also want to factor in provider access, emergency coverage while traveling, and whether your favorite doctors are in-network.

Step 4: Evaluate Prescription Drug Coverage

Prescriptions can be one of the largest out-of-pocket expenses in retirement. A key part of any Medicare benefits review is making sure you have the right Part D coverage—either standalone or through a Medicare Advantage plan.

Factors to evaluate:

• Are your current medications covered?
• Which pharmacy networks are included?
• What are the copays and deductibles?

Each Part D plan has a formulary, which is the list of drugs it covers. Formularies can change yearly, so even if your medications are covered now, it’s important to verify they remain listed in the next plan year.

Some plans may include step therapy, quantity limits, or prior authorization requirements. Understanding how these rules affect your access to medication is crucial for avoiding delays in treatment or surprise costs.

Step 5: Get Help from a Medicare Benefits Specialist

You don’t have to navigate Medicare alone. A comprehensive Medicare benefits review with a licensed benefits advisor ensures:

• Your plan aligns with your health and financial goals
• You’re not overpaying for coverage
• You’re taking advantage of every available benefit

Specialists bring deep knowledge of plan options and local networks. They can help with:

• Reviewing plan changes and provider availability
• Comparing multiple carriers in one appointment
• Identifying eligibility for savings programs like Extra Help or Medicaid

At Bene-Care, our Medicare specialists walk you through the review process step by step—comparing plans, answering questions, and simplifying complex decisions.

Why Work With Bene-Care

Choosing the right Medicare plan isn’t just a one-time decision—it’s a yearly opportunity to improve your healthcare experience. When you work with Bene-Care, you get:

✔  Personalized Medicare benefits review and plan comparison
✔  Local experts who understand New York’s healthcare landscape
✔  Trusted guidance with no obligation or high-pressure sales
✔  Support before, during, and after enrollment

Connect with Bene-Care on LinkedIn to stay informed on healthcare trends and enrollment reminders.

Ready to Schedule Your Medicare Benefits Review?

Making confident, informed decisions about Medicare starts with getting the right information at the right time. Let us help you:

• Navigate plan options
• Avoid coverage gaps
• Save money on premiums and prescriptions

Call us today at (585) 347-1300 or visit our contact page to schedule your complimentary Medicare benefits review.

Take the guesswork out of Medicare. With Bene-Care on your side, you can choose the right plan with clarity and confidence.