If you are turning 65, or are enrolled in Medicare and want to make changes, the time to do so is from October 15 to December 7 during Medicare Open Enrollment season.
Open Enrollment is all about understanding the benefits of Medicare so you can make the right decision. It's about keeping you on the road to health while getting the most from your specific Medicate option.
More than ever, NOW is the time to finally get the best care at an affordable price!
These are the most asked questions that I get from my clients:
Original Medicare is provided by the Federal Government, whereas both, Medicare Supplemental Insurance and Advantage Plans are offered by private companies.
Because not all costs are covered under Medicare Parts A, B & D, enrolling in an additional insurance plan that helps with the costs is typically recommended.
This is what happens when you turn 65 and are no longer covered by an employer plan:
This quick guide may help you navigate the options:
Both Plans are offered by private insurance companies, and cover services that Original Medicare doesn't. Examples include skilled costs related to a nursing facility care (for 100 days), coinsurance/copayment for hospice care, additional hospital costs, excess charges that may occur in a health-related event or international emergency services.
In an HMO Advantage Plan, costs associated within a 'network' will typically offer more affordable options. However, if you have been working with a specific team of doctors and want the freedom to change doctors, then a Medi-Gap option would be better for you.
The cost varies, and again, will depend on how comprehensive you want your coverage to be. I find this summary helpful when discussing the differences between Medi-Gap and Medicare Advantage Plans:
• What happens if I miss enrolling during open enrollment season?
Let me start with... don't!
Both Medicare and most Advantage Plans may offer an extended grace period of a couple of weeks, like last year. But don’t risk it. Mark your calendar and make sure that you meet with your insurance broker to get the plan you need or make the changes you deem necessary.
Here are the basics as far as enrollment for Medicare is concerned:
1. When you are leaving an employer medical plan
2. When you are moving to another state
3. If you qualify for Medi-Cal
4. When you go into a nursing home
Make sure there is an in-depth understanding of YOUR options. How’s your health? Will you need additional services down the road? Work on a plan that covers YOUR needs. Let’s face it: as we get older, our sight and hearing are not so good. Many advantage plans offer additional benefits that you might want to consider when shopping for a plan, mainly those associated with Dental/Vision/Hearing benefits.
Make sure you are caitalizing on all the additional benefits offered. Some Advantage plans, may include a wellness program that establishes a concrete plan of action based on your health. This may include disease screening, exercise routines, depression screening, smoking cessation counseling, alcohol counseling, or obesity counseling. Some plans may include perks such as discounted prices at gyms (silver sneakers), rides to medical appointments, access to your doctor or nurse via telephone or meals delivered to your home.
Please, please, please! Remember to make sure you confirm your doctor is “in network”, especially if considering an Advantage Plan.
Medicare.gov went through major changes this year, the first in 10 years! It may have some glitches, but the overall information is very useful, especially regarding information on Part D.
Enrolling in a Medicare plan that covers YOUR specific needs requires significant research. Ultimately it will depend on your health care needs vs. your budget: what complements your lifestyle the most, Medicare Part A, B and D with a Medicare Gap policy, or a Medicare Advantage plan?