The new open enrollment period is now underway until December 7, so it’s time to get up to speed on all your choices, and the best coverage for you.
After spending ten years working for the largest Medicare health plan in the U.S. many moons ago, I learned a thing or two about the many choices available, and how to make the best individual choice for those fortunate to have Medicare.
Medicare Open Enrollment – Your Annual Health Plan “Re-Set Button”
For instance, this is now the time of year (the Medicare open enrollment period runs October 15 through December 7) when retirees with Medicare can take a fresh look at their health plan and decide which version of Medicare works best for them, and if they want to make a change.
This is a great opportunity for anyone already enrolled in Medicare and for anyone approaching age 65 – the age you can enroll for the first time in Medicare.
Let’s Break it Down
Let’s face it, when you think of government bureaucracies, simplicity is not usually the first thing that comes to mind, and Medicare is no exception. The confusion usually starts because there are four basic versions or parts to Medicare, and each offers different types of coverage. Here are the basics according to the 2018 Medicare Handbook:
Medicare Part A – This insurance covers hospital care. Most pay no premium if they’ve worked long enough to qualify for Medicare.
Medicare Part B – This covers doctors visits and outpatient services. Monthly premiums in 2019 will range from about $135.50 per person to $460.50, depending on your income.
Medicare Advantage (Part C) – This is an alternative to Original Medicare and is offered by private insurance companies contracted with Medicare. Generally, Advantage plans cover the same services as Original Medicare, and they often also offer extra benefits such as eyeglasses, dental care, health club memberships, and most include prescription drug coverage.
Medicare Part D – This is prescription drug coverage.
Four Steps to Your Best Plan
I recently went through this process with my own parents, and found the process easier by breaking it down to four simple steps:
Step 1 – First make a list of your drugs and dosages. This will come in handy whether you are considering a Medicare Advantage Plan or choosing a prescription plan to supplement Original Medicare.
Step 2 – Read your “Annual Notice of Change” letter sent by your existing plan around the end of September. This spells out any changes in your plan. Pay careful attention to any current coverage of drugs or benefits dropped for the upcoming year.
Step 3 – Choose between Original Medicare and Medicare Advantage. Advantage plans usually are less costly and have richer benefits, but you generally must utilize local networks of doctors and hospitals. On the other hand, Original Medicare gives you a much broader choice of medical providers, but you’ll want to consider a private insurance Medigap policy to cover costs Original Medicare doesn’t cover, which comes at an additional premium.
Step 4 – Make the decision of keeping Original Medicare (and Medigap policy) or switching to a Medicare Advantage Plan. Much will depend on where you live. In some parts of the country Medicare Advantage Plans have lots of additional coverage and wide networks of contracted providers.
Also, definitely check out the excellent website at medicare.gov that compares the different plans by local county, and also compares prescription plans in great detail.
I was pleasantly surprised how helpful and easy the Medicare website was to navigate to get the information my parents needed to make the absolute best decision for them!
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