Here are 3 vital things you need to know when reviewing your Medicare Plan during open enrollment:

#1: Is you Primary Physician on the Plan for 2016. If you have primary care doctors or specialists you have been using, and want to keep using, make sure they will continue to be in the network of the Medicare Advantage plan where you are enrolled. The networks, which are the lists of approved doctors and hospitals by the Medicare Advantage plan, change frequently. Ask your doctors now if they have signed up to continue in the plan for 2016. If the doctors have dropped out, you could face a big financial risk. If you go outside the network of your particular plan, you may be required to pay a much larger share of the cost, and in some, cases you may have to pay the full cost without any reimbursement from the insurer.

“Will I be able to use my doctors? Are they in the plan’s network?
Do doctors and providers I want to see in the future take new patients who have this plan?
If providers aren’t in the network, will the health plan still cover my visits if I choose to see them?
Who can I choose as my Primary Care Physician (PCP)?
Does my doctor need to get approval from the plan to admit me to a hospital?
Do I need a referral from my PCP to see a specialist?”

#2: Which specialists, hospitals, home health agencies and skilled nursing facilities are in the plan’s network? Plans change form year to year. For example, in 2016 Blue Shield now has a contract with Community Memorial in Ventura, which is great news for residents of Ventura.

#3: Check your drugs for coverage under the plan. The list of approved drugs by Medicare Advantage plans, called a formulary, is constantly changing. Plans add and remove drugs, and change the co-payments and deductibles for these medications.

Check the preferred pharmacy list to make sure there is a drug store conveniently close to you. The drug prices depend on buying the medications at a pharmacy which has a contract with the health plan. Many plans are now using lists of preferred pharmacies, where the price will be cheapest. It can make a substantial difference, so you want to use a preferred pharmacy whenever possible. Make sure the plan has one located conveniently near you.