Yes, Medicare recipients, it is October and the Medicare Open enrollment doors have officially opened and will remain so until Dec. 7. During this time Medicare recipients can (unless notified from their plan) opt to remain with their current coverage or enroll in a different plan. This might include switching from a traditional Medicare Plan to a Medicare Advantage Plan or change Part D (prescription drug coverage). As so often the case, an educated consumer is the best customer, so do your homework.
Very briefly, people with Medicare can receive their health coverage through original Medicare (red, white and blue card) or a Medicare Advantage Plan. All Medicare products provide Part A and B benefits, with similar deductibles and premiums. However, Medical Advantage beneficiaries cost structure along with service options can often vary from traditional Medicare. For example, unlike traditional Medicare, some Medicare advantage plans may cover some ancillary services such as routine vision, hearing and dental care.
Those who choose coverage through traditional Medicare will need to (if not already insured), purchase a Part D (Prescription Drug Plan) or, risk a financial penalty. Also, because Part B coverage is not comprehensive (usually 20 percent co-insurance) one may also choose to buy supplemental insurance (Medigap). Keep in mind, however, if not purchasing Medigap during “no questions asked period” such as the six-month period beginning when turning 65 among a few other protected enrollment times, Medigap insurance can be quite costly, delayed or denied.
Those covered under a Medicare Advantage Plan need not enroll in a separate drug plan (unless advised by the plan) nor purchase supplemental health insurance. While those with traditional Medicare are able to see any provider who accepts Medicare, Medicare Advantage plan owners may be responsible for significant out of pocket costs should they receive care from out of “network” providers.
Even if satisfied with your current plan, take some time to review 2016 health care costs to determine if there are better cost and coverage options for 2017. Although a plan may have lower premiums, it still may end up costing more overall if it is offset by expensive copayments and deductibles or a high out-of pocket maximum. Consumers who are considering changing plans such as switching to a Medicare Advantage Plan are encouraged to review the plan with preferred providers insure coverage (check with both the plan and provider).
To help find additional answers help is available from the Ohio Department Insurance OSHIIP volunteers (link below). As well, since Medicare has ranked Medicare plans by quality and customer satisfaction, consider reviewing top rated plans (ranked 1-5 stars). Finally use the Medicare formulary finder to find a plan most suited to one’s prescription medications.
Online tool to review plans/medication fit: www.medicare.gov/find-a-plan/questions/home.aspx
Ohio Department of Insurance (Medicare Check-up Days and locations): Call 1-800-686-1578 or go online to www.insurance.ohio.gov/Consumer/OSHIIP/SitePages/CheckUpDays.aspx.
Marci Vandersluis is a licensed social worker and has a master’s degree in gerontology. She is employed as a care manager assisting older adults in the community connect with needed services. Email: firstname.lastname@example.org.