Its decision time for the 55 million Americans covered by Medicare, and making the wrong choices during the open enrollment process can prove costly!
Open enrollment, when people can enroll in Medicare or make changes to their plans, runs every year from Oct. 15 to Dec. 7.
But it’s important people realize enrolling in Medicare can be complicated. If you don’t pay attention you can end up missing needed coverage or paying more out-of-pocket expenses in premiums, co-pays and deductibles than you realize — or can afford.
Every year, Medicare offers an open enrollment period allowing new enrollments, or current recipients to make changes to their plan. Medicare is not a one-size-fits-all program, and in fact it offers a large variety of choices that people can elect to put together the best combination of benefits for their needs and budget.
People need to realize that enrolling in Medicare can be complicated, and if you don’t pay attention you can end up missing needed coverage or paying more out-of-pocket expenses in premiums, co-pays and deductibles than you realize — or can afford.
Medicare coverage comes in two primary forms that participants can choose from. There is original Medicare, the traditional program administered through the federal government which anyone 65 and older qualifies for automatically, and Medicare Advantage plans, which are sold by private insurance companies. The Advantage plans sometimes offer additional services, such as routine vision, hearing and dental care.
Most people probably have heard of Medicare Part A, Medicare Part B, or Medicare Part D. Here’s how that alphabet soup breaks down: Medicare Part A pays for hospital and skilled nursing facility care. Medicare Part B pays 80 percent of costs for doctors, outpatient services and medical equipment. Medicare Part C is a private Advantage Plan. Medicare Part D pays for prescriptions.
Anyone who visits a doctor or has been hospitalized knows that deductibles and co-pays can add up quickly. That’s where Medicare Supplement Insurance (Medigap) comes in. It’s a private insurance that pays the gaps in the varieties of Medicare coverage.
Whether you are joining Medicare for the first time, or thinking it’s time to make changes to your current plan, here is a helpful Medicare information checklist everyone needs to know:
- Open Enrollment runs every year from October 15- December 7.
- You have two primary forms of Medicare coverage to select: Original Medicare that you qualify for automatically, or private Medicare Advantage Plans.
- Medicare Advantage Plans are managed by health insurance companies for the cost of monthly premiums offering additional services, and usually Part D Prescription plans.
- Medicare Part A pays for hospital and SNF based rehabilitation based care.
- Medicare Part B pays 80% of costs for doctors, outpatient services, and medical equipment.
- Medicare Part C is a private Advantage Plan.
- Medicare Part D pays for prescriptions.
- Medicare Supplemental Insurance (Medigap) is private insurance that pays gaps in the varieties of Medicare coverages.
Assistance is available to help people understand and navigate enrollment. Agents who specialize in Medigap and Medicare Advantage Plans can help with initial enrollment and open enrollment. Free assistance can also be obtained through the State Health Insurance Assistance Program (SHIP) and the Medicare Rights Center. Also, the Center for Medicare and Medicaid Services (CMS) website (www.cms.gov) provides a wealth of information and resources to review and assist enrollment. It is important to not wait until the last minute.
When it comes to Medicare enrollment don’t procrastinate! Not being informed, missing deadlines, or making the wrong selections can cause delays and penalties that could have a negative impact on your coverage — and your wallet.
Chris Orestis, executive vice president of GWG Life, has more than 20 years of experience in the insurance and long-term care industries and is nationally recognized as a healthcare expert and senior care advocate.
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