Whether you are a new enrollee or have been on Medicare for years, the Annual Enrollment Period (AEP) is a critical time to evaluate your coverage options. With several types of plans, supplements and degrees of coverage, deciding on the Medicare plan that is right for you can be overwhelming.
First-time enrollees should not wait until the last minute to sign up for Medicare. If you miss the deadline to enroll, there are late fees. If you recently retired, you could be left without health insurance depending on when your plan expires. Begin researching all your options early to minimize stress later.
You’ll start with Original Medicare (Part A & B) then you’ll need to decide if you want a Medicare Advantage plan or Medicare Supplement (Medigap) to fill in the financial gaps in Parts A and B coverage. Part D covers prescription drugs. Depending on the path you choose, you will need Part D for drug coverage unless your prescriptions are covered by another source such as Tricare for Veterans. Medicare Advantage plans (Part C) offer a bundle of Part A, B, and D.
Consider Senior Financial Group’s checklist for your Medicare coverage options before enrolling or to see if any adjustments need to be made to your current coverage.
- Effectiveness of the Current Plan: Is your current plan offering you the best coverage at the best price? Are your current prescription medications still covered by your Part D plan? Are your health care providers still in your network? Does your plan cover you when you travel? For current beneficiaries, you can always change your plan during Annual Enrollment. For new enrollees try to find a plan that will be effective for you now and in the future.
- Costs: Costs will fluctuate between each plan and it is important to understand the out-of-pocket costs before signing up. Does your plan limit your annual out-of-pocket costs? Original Medicare does not have a cap on out-of-pocket spending each year and does not cover prescription drugs, vision, hearing and dental. A Medicare Supplement, Medigap, can be purchased to cover the 20% Original Medicare doesn’t cover. The other option is an Advantage Plan which covers doctors, hospitals, drugs and extra benefits such as vision, dental and hearing with an annual out of pocket maximum. Both options are offered by private insurers and usually require a monthly premium. There are some Advantage Plans offered at a zero premium.
- Coverage and Medical Professional Choices: Every year, review the newest Medicare changes to make sure your current health care provider and prescription drugs are still covered. Certain in-network providers accept Medicare, but the list changes periodically. Part A covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery and home health care. Part B covers doctor and other health care providers’ services and outpatient care, durable medical equipment, home health care and preventative services. Medicare Supplements cover a range of other items depending on the plan while a Medicare Advantage plan combines all the parts under an HMO/PPO type of network.
- Prescription Drug Coverage: Prescription drugs can be the largest expense in retired life. Without insurance, you could pay thousands of dollars in out-of-pocket costs. If you choose Original Medicare, consider adding Part D to your coverage. Check the approved drug list annually to make sure your plan will still cover any needed medications. If they are no longer covered, use the Annual Enrollment Period to switch plans without penalty. Most Medicare Advantage plans have prescription drug coverage built-in, but if not, Part D can be added.
- Quality of Care: Make sure you are getting the most out of your Medicare plans. The quality of medical providers and the care you receive can vary. Adjust your coverage as needed during the Annual Enrollment Period. To find the highest-ranked healthcare providers, visit Medicare.gov or talk to one of our experienced advisors.
If you are still unsure about which plan is right for you, talk to one of our Medicare specialists. With years of experience and integrity to match, Senior Financial Group will make sure you get the best plan for the best price. Remember, AEP ends on December 7th.
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Sources: Medicare.gov; Washington Post