Medicare Open Enrollment is the time of year an individual may change or start Medicare coverage. Each year, seniors and qualifying disabled Americans must take action to choose a Medicare provider between October 15th and December 7th. The decision made will directly impact an individual’s finances and health care needs over the following year.
We know choosing a Medicare plan can be complicated. Whether you are a 65 year old who is enrolling in Medicare for the first time or a seasoned beneficiary who is looking to make plan changes, we want to share five tips with you. These tips, which we share with our clients and the professionals we work with, are designed to help make this complicated process a little bit easier.
1. Read your mail each day.
It is easy to sift through your mail each day and barely look at the pamphlets you receive before tossing them into the trash. When it comes to Medicare Open Enrollment, however, it is not always junk mail. If you’re already enrolled in a Medicare Advantage or drug plan, you’ll be sent either an Annual Notice of Change (ANOC) or an Evidence of Benefits (EOB). These notices inform you of your costs and benefits changes for the upcoming year. Be sure to read these in full because the information furnished is typically a crucial factor in your decision to keep your current plan or enroll in a new one for the next year. Never assume your plan will stay the same year to year.
2. Learn the difference between traditional Medicare and Medicare Advantage.
Not all Medicare plans are created equal. You need to know the difference between the Medicare plans. Traditional Medicare is run by the government. Plan recipients may go to any medical provider who participates in the program, most medical providers are included. Traditional Medicare, however, does not cover dental, hearing or vision care. Medicare Advantage plans are offered by private insurers. While they restrict members to their network of doctors and hospitals, they can cap out-of-pocket expenses and cover more than only medical care.
3. Be sure your doctors are in your plan’s network.
Remember, Medicare Advantage plans are restricted to a specific network of doctors, hospitals and other providers. If you decide to enroll in a Medicare Advantage plan, be sure your current medical providers are within the plan’s network. This may change from year to year with the end result being your need to change your plan during Medicare Open Enrollment.
4. Know the ABC’s of Medicare.
Could there be more letters? Medicare Part A covers hospital insurance. Medicare Part B covers medical insurance and there are penalties if you fail to enroll when you are first required to do so. Medicare Part C is another term for the Medicare Advantage Plans. Medicare Part D adds prescription drug coverage to Traditional Medicare.
5. You may qualify for a subsidy.
If your annual income is at a certain threshold, you may qualify for a subsidy that can help pay for the premiums that arise from certain drug plans. You may also be eligible for a subsidy to reduce the costs of Traditional Medicare. Determine if your subsidy covers the premiums you will face for the upcoming year or you may be billed for the difference.
If you are unsure what type of coverage you currently have, check your red, white, and blue Medicare card or any additional insurance cards. This is the time to talk to qualified plan providers and read the details regarding each plan. Making a choice is personal and dependent on your own unique health needs. Don’t wait to find the right Medicare plan for you.
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Kevin Snyder is a husband, father, and an Orange County estate planning attorney and elder law attorney at Snyder Law, PC in Irvine, California. He is all about family and has a passion for educating his community about trust and estate planning, veterans issues, and how to protect what matters most.