Bombarded by Medicare information? Don’t let Medicare mail fool you.
As we approach Medicare’s Annual Enrollment Period, Medicare-eligibles will start to receive a lot of information about Medicare and their medical insurance options (hospital insurance, medical insurance, drug coverage), especially through brochures and mailers advertising the best Medicare Advantage plans with the best Medicare benefits. Don’t be fooled. There’s no way for someone to know the most appropriate Medicare plan for you without knowing more about you, such as the prescriptions you take and the doctors you see. To help guide you through this process requires a needs based assessment by a Medicare professional.
It is important to know what Medicare doesn’t allow. For example, Medicare doesn’t allow Medicare Advantage plans to claim it is the “best” Medicare Advantage plan available. Medicare Advantage plans, which are offered by private insurance companies (unlike Original Medicare which is a federal government program), vary by monthly premium, out-of-pocket costs, benefit costs, in-network providers, and prescription drug coverage. Sales people are not allowed to “cold call” or solicit you in person or by phone without you initiating contact. You can only be contacted, other than by mail, by your own agent.
Many Medicare Advantage plans offer additional benefits including, dental benefits, vision coverage, hearing aid benefits, and health and fitness programs, which also vary by plan. Medicare Advantage coverage varies in the cost shares for services such as inpatient care, outpatient care, physicians and lab work to name a few. It is important for Medicare beneficiaries to know that the most appropriate Medicare health plan for you is based on your individual needs. Because everyone’s needs are different, a Medicare professional can most adequately guide you. Be careful not to seek advice from individuals or agents not certified to sell Medicare health and drug plans.
Whether you have an Advantage plan, Medicare Supplement insurance, or Original Medicare from the United States government, a Medicare beneficiary can change their plan every year during annual enrollment (October 15 – December 7). During this time, you can either sign up, drop or switch to a different Medicare Advantage or prescription drug plan. As enrollment in Medicare increases, insurance companies are offering more Medicare Advantage options (POS plans, HMO plans, PPO plans, and DSNP) for Medicare beneficiaries, including additional benefit options such as dental and vision coverage, eyewear benefits, and health and wellness programs. So, it’s smart to shop around for a Medicare Advantage plan during the Annual Enrollment Period, review your Medicare options, and compare your current coverage to the plan options for the following year. As your needs may change year to year, plans also change year to year, so don’t miss the opportunity to find a plan that better fits your needs. An independent agent certified to sell plans from multiple carriers will be your best source for guidance.
If you are reviewing information about Medicare, make sure you are using trusted and secure websites, like the official federal government website – https://www.medicare.gov/. An official government organization, like the Centers for Medicare & Medicaid services, is also a good resource.
Fortunately, a licensed insurance agent specializing in Medicare plans can help you make a more informed decision about Medicare coverage based on your specific circumstances. If you are getting ready to enroll in Medicare for the first time, our agents can help walk you through the process and identify which plans best fit your current needs.
What about Medicare prescription drug coverage?
You can also add a Medicare prescription drug plan or switch to a different drug plan during annual enrollment. Prescription drug coverage is available through Original Medicare, commonly referred to as Medicare Part D, but you can also get drug coverage through an Advantage plan. A specialist can also help you evaluate your Medicare drug coverage plan options.
I currently have health insurance through my employer, what now?
You can still keep your health insurance if you are still working and currently receiving coverage through your employer. If you qualify for premium-free Part A, in some cases, it’s a good idea to enroll in Medicare when you turn 65 even if you delay your Part B enrollment while you work. It can supplement your employer’s inpatient hospital coverage, and you won’t pay an additional monthly premium. Once you lose your employer coverage, you can sign up for Part B during your 8-month Special Enrollment Period (SEP). However, if you are Medicare-eligible and your employer has less than 20 employees, Medicare becomes the primary payer, and your employer plan is secondary. Therefore, you should sign up for Medicare when you’re first eligible during your 7-month Initial Enrollment Period. If your employer group plan is not considered creditable, staying on the plan after you are Medicare eligible may result in a penalty.
What if I receive Medicaid services?
If you are receiving Medicaid services at the time you become Medicare eligible, you are what is considered dual-eligible. You may receive coverage from both and Medicare will first pay expenses with Medicaid covering what is left. Most carriers have plans specific for “dual-eligibles” called DSNP. These offer expanded benefits as $0 premium.
Talk with an Agent Specializing in Medicare Health and Drug Plans Today!
Let’s chat! There’s a lot of information out there! Contact our dedicated team to review the Medicare Advantage and prescription drug plans available in your service area and find the right plan for you. Call our Medicare Division at 860-379-2885 or email ann@bowenagencyllc.com for an appointment.