As the leaves change, it should also serve as a reminder that it could be time to look at changing your Medicare health plan or drug plan. From Oct. 15-Dec. 7, is a period called “Medicare Open Enrollment.” This is a special time of the year to look at changing plans, or just re-evaluating what coverage you have to get the most out of your Medicare needs. This time of the year is for Medicare part D plan and Medicare Advantage Plan changes.
You may not have to change anything if you like your current coverage. You don’t need to do anything as long as you pay your premiums, they will renew your coverage. But, please pay attention to notices from your insurance plans in the next few months as this is when they will be letting their clients know of their changes to next year’s plans such as rates, and drug formula changes. Understanding your Medicare coverage is crucial when you are making changes.
Medicare does not cover any prescriptions without being enrolled in a Medicare-approved drug plan. Some folks who have original Medicare add a Part D drug plan to their Medicare parts A and B for drug coverage. Those who have this original Medicare coverage also have the option to purchase additional health insurance plans that work with original Medicare to cover the gap in cost of healthcare that Medicare would not normally cover. These are called Medigap or Medicare Supplement plans. Medicare covers certain services at 80% after deductibles are met, and you could be billed 20% coinsurance after those are met. Medigap or supplement plans pay the balance of those plans but it comes at a cost of a premium that you pay each month-whether you use it or not.
Medicare Advantage (MA) plans are different and are not “supplemental” plans. They are privatized insurance that work with Medicare and become your Medicare coverage. They set the copays and coverage by working with healthcare providers and facilities to settle for a set amount in lieu of the normal rates that Medicare could charge folks on original Medicare. These companies are also allowed to offer benefits that Medicare may not offer as extra incentives to join. Many also include part D drug coverage and thus eliminate having a separate drug plan. Not all Medicare Advantage plans are the same and aren’t available in all areas. TV commercials are very deceiving at times, so do some research on a new MA plan to know just what you are going to receive.
You can get more information about comparing plans by calling 1-800-MEDICARE after Oct. 15. You can also get assistance from an independent MMAP counselor. CAA/Menominee Senior Center has a MMAP counselor on-site to assist with your Medicare needs by appointment only.
Renelle Betters is the director of CAA/Menominee Senior Center.