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Here we go... again! The top questions you need to know before this year’s Medicare open enrollment

That time of year is almost here. That time when we start asking ourselves about the best healthcare plan out there after we turn 65. Susana Leon Krieger helps us navigate through the most frequently asked questions, and discusses the benefits of making an informed decision when navigating the Medicare alphabet soup of options.

If you search for the term “Medicare” on your search engine, you will see “99,200,000 results in 0.99 seconds”; each one addressing as many case scenarios as individuals who are either turning 65 this year and need to enroll, or make changes to their existing plans. To top it all off, yearly changes to Medicare laws seem to make navigating the yearly enrollment season ever so confusing.

In some cases, access to the information that will guide us to make the right decision might be hard to find. “As an insurance professional, we get informed on the expected changes in Medicare and trained on any new benefits on a yearly basis, so that in turn, we can strategize with our clients the best option for their particular circumstances”, comments Susana Leon Krieger. No question will ever be a silly question.

What options do I have?

For those of you who are about to embark on the Medicare adventure, this summary might be redundant at best, confusing at worst. To simplify:

  • You will automatically be enrolled in Medicare plan A&B when you turn 65.

  • If you are not satisfied with the services provided in plan A & B, you can enroll in Medicare Advantage, which operates the same way as your typical health insurance and at a significantly lower cost and may cover expenses that the typical Medicare Parts A & B do not cover.

  • Prescriptions are expensive. There is no way I will ever recommend anyone to skip Part D

  • Don’t delay in enrolling. Penalties for failing to enroll can be costly

Having said that, this is a summary of the general Medicare highlights:

Do I have to have Medicare?

The question would be why not? Think about it. Chances are that as we age, our body well... just doesn’t work like it used to; even if we are the healthiest person on the planet! Medicare, as all forms of health insurance, should be a preventive measure, rather than a reactive one –especially when life can change in an instant! The advantage of Medicare is that typically, the combination of all the alternatives out there provides the care that you need at affordable pricing.

So, is it illegal not to have Medicare? Tricky question. If you are receiving Social Security benefits, you will automatically be enrolled in Medicare Part A. Period. You can waive your enrollment if you decide to forfeit your Social Security benefits. But then, why would you? After all, you have been paying into Social Security your entire professional life. If you are still working at 65 and can prove enrollment in a healthcare plan, you can opt out of certain parts of Medicare.

“The best option for you will always depend on your personal circumstances”, comment Susana. “There are many possibilities of optimizing the benefits of your health coverage. If you have any questions on how to navigate the puzzle of Medicare, give me a call.”

What are the factors I need to consider when enrolling in Medicare?

Enrollment in Medicare is about putting a health puzzle together with the best options and taking into consideration your personal circumstances. It’s about strategizing what is best for you and your family’s health.

Strategizing about the best health coverage for you may include:

  • Is your current doctor in the Network of doctors?

  • Are you or are you planning to enroll in Medicare’s Advantage Plan? What are the Benefits

  • Which of your prescriptions are covered under which plan?

  • Do you think you will be needing a specific treatment down the road?

  • Are you considering enough for your care needs in your budget?

Why is open enrollment so important?

I often define to the open enrollment season as an opportunity to review if your coverage is appropriate for your needs, are the options convenient for you, and is the cost within your budget.

Open enrollment season gives us the opportunity to understand Medicare, review our options, rate the satisfaction of the services we get from our plans, and make the specific changes accordingly. If enrolled, one is only allowed to make changes to current health plans once a year, from October 15th, to December 7th. Failure to enroll might result in penalties. As to why people adjust their Medicare options, reasons include but are not limited to:

  • Cost adjustments

  • Changes in the Network of Doctors

  • New treatments or prescriptions

  • Turning 65

  • Pre-existing conditions

“My function is to be your partner. The basic Medicare plans mentioned above are just a very basic summary of what Medicare entails. As with many care plans, there are other alternatives that might meet your requirements better that are definitely worth the while to look into; however, it all starts with the basics. By providing you with all the information related to Medicare, and by taking the status of your own situation into consideration, I can help you strategize what the best option will be for you”

Ready for the puzzle of Medicare? I am here to strategize on the best option for you!

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