If you’re 65 or older, you probably know that the Medicare Annual Enrollment Period runs Oct. 15 through Dec. 7. Generally, this is the only time you can make changes to your coverage.
According to Herb Fritch, president of Cigna-HealthSpring, a leading health service company and Medicare insurance provider, here are some things to consider:
• Determine priorities. Make a list of priorities — such as lowering out-of-pocket costs — and use it to compare plans.
• Understand the different parts. Part A refers to hospital insurance. The amount of the deductible depends on the length of the hospital stay.
Part B refers to basic medical insurance for doctor visits and other health care services. Medicare pays 80 percent of approved charges while you pay 20 percent in addition to a monthly Part B premium and annual deductible which will vary based on your income. Supplemental plans like Medigap and Medicare Advantage can help cover the 20 percent gap and most offer extra benefits.
Part C refers to plans operated by private companies that combine Part A and B benefits. Most include Part D prescription drug coverage, offer no or low monthly premiums, and extras like vision, dental and gym membership benefits.
Part D refers to Prescription Drug Plans offering at least a standard level of coverage set by Medicare; some are available as stand-alone plans.
• Do your research. Benefits differ from company-to-company and even state-to-state, so do your research. Look beyond premium cost to ensure there aren’t hidden copays or fees that will end up costing you more. Pay close attention to medication quantity limits and make sure your plan offers adequate drug coverage.
• Pay your Medicare Part B premium. Even if you’re enrolled in a private Medicare plan, you must continue paying your Part B premium. If you’re having trouble, contact your local Medicaid office to see if you qualify for a Medicare Savings Program.
• Don’t settle. Priorities change, so the plan that worked when you were 65 may not be best when you’re 75. Plans also change year-to-year so review before renewing.
• Know your network. Many plans offer choices with a network of doctors. If you visit a doctor out of network, you could be responsible for out-of-pocket costs. However, networks offered by Medicare Advantage choices, such as Cigna-HealthSpring, can foster better coordination among doctors, leading to better care. Ask your doctors what plans they accept or check your network directory.
• Don’t worry about the Exchanges. With a few exceptions, Medicare will be a better option than the Exchanges (also called “Marketplaces”). In fact, it’s illegal for someone to sell you an Exchange plan if they know you have Medicare.
• Use free resources. The Centers for Medicare & Medicaid Services’ Plan Finder helps you compare costs, covered medications and other items. Many insurance plans offer free seminars with no obligation to sign up. You can also check companies’ websites or call their Customer Service number for more information. Local agencies on aging can also be helpful.
This open enrollment period, make sure your health plan works for you.