Medicare open enrollment season is quickly approaching. During this time, Medicare beneficiaries make important choices that affect their medical costs, the doctors they see and prescription coverage for next year.
Whether they are enrolling in Medicare for the first time or looking to change their coverage during Medicare’s annual enrollment, Dr. Anne Docimo, chief medical officer of UnitedHealthcare and responsible for outcomes of more than 50 million Medicare members, offered some useful tips and information to help older adults, their caregivers and newly eligible beneficiaries on what they need to know about signing up or renewing benefits during this open enrollment season.
Docimo said, “When can people enroll in a Medicare plan? Timing is everything, and a lot depends on your specific situation. You have a seven-month window around your 65th birthday to enroll. It includes your birthday month plus the three months before and the three months after. It’s best to sign up early to avoid gaps in coverage and late enrollment penalties.”
For people already enrolled in Medicare, annual enrollment runs from Oct. 15 to Dec. 7, and allows you to make changes to your plan or enroll in a new plan. If you have a qualifying life event, like a move, you can get a special enrollment period to switch plans during the year.
What should people think about as they compare their Medicare coverage options?
“When it comes to Medicare, one size does not fit all, Docimo said. “That’s why it’s great to have options to choose from. You need to take the time to explore your options and understand the benefits and costs of each plan so you can find the coverage that works best for you.
“I suggest asking a few key questions such as: Is your current coverage still meeting your personal health needs, and will your benefits change next year? If you’re enrolled in a Medicare Advantage plan, you should have received a document called the annual notice of changes. Make sure you take a look at that document so you’re not caught off guard by any changes to your plan.
“Is your coverage a good fit for your budget? It’s important to pay attention to more than just the monthly premium. You should also understand the other out-of-pocket costs, including the deductible, copays and coinsurance.
“Are you comfortable with the doctors and hospitals that are available with the coverage you’re considering?
“Are your medications on the formulary or approved drug list? Plans’ drug list can change from year to year, so even if your drugs are covered this year, it’s important to review the materials you receive from your plan to make sure your drugs will still be covered next year.
“Does the plan offer additional benefits that are important to you, such as coverage of dental and vision care or a gym membership?” Docimo said.
What do the different “parts” of Medicare mean?
Medicare has four main parts – A, B, C and D.
Original Medicare includes Parts A and B. Part A provides coverage of inpatient care in hospitals and skilled nursing facilities, as well as hospice care and some home health care. Part B provides coverage of the costs of doctor visits, outpatient hospital services, some home health services and durable medical equipment. It also covers some preventive health care.
Part C, also known as Medicare Advantage, is an option for Medicare coverage that combines Original Medicare Parts A and B into one plan offered by private health insurers. Medicare Advantage plans often also include prescription drug coverage and other additional benefits not included with Original Medicare.
Part D helps with the cost of prescription drugs.
There’s also what’s known as Medicare supplement plans. These plans help cover some of what Medicare Parts A and B don’t pay, such as portions of coinsurance, copayments and deductibles.
Where can people go if they are looking for more information?
“Consider exploring online resources and webinars from the comfort of your own home,” Docimo said.
Visit http://www.GetToKnowMedicare.com to access a virtual event, webinars, find a local agent and other helpful resources to help older adults make confident Medicare decisions.
Gregory Wright is CEO of Medicare and retirement for UnitedHealthcare in California.