MAKING SENSE OUT OF MEDICARE
You’ve probably asked yourself, "do I have the right coverage and if not, how do I figure out what’s right for me?" If this is the beginning of your Medicare experience, you’re mailbox is probably filled with tons of information from various Managed Care plans that offer Medicare products. The wealth of information you are expected to understand can be baffling. How do you figure it all out?
Medicare open enrollment begins October 15th and ends December 7th so you have much less time to make any changes to your current plan. Let’s take a look at your options:
• Original Medicare: Many of seniors as well as those who are not 65 and have Medicare because of a disability or have End-Stage Renal Disease are covered under Part B. You pay a monthly premium that is taken out of your Social Security check each month. With Original Medicare, you can use any hospital or facility and see any physician of your choice. You have a yearly deductible that has to be met before Medicare pays (the deductible for 2011 is $162.00). Because Original Medicare only pays 80% after your deductible is met, most people cover this gap by purchasing a Medigap policy or supplemental insurance. These plans are sold by private insurance companies and they all have to follow state and Federal laws. The plans sold in NC are standardized which means that the benefits are the same regardless of the insurance company. The only difference between what companies sell is the cost!
• If you have original Medicare, you will also need to purchase a Part D (prescription drug) plan unless you have retiree benefits with drug coverage through your former employer. Companies that sell Part D coverage are all approved by Medicare. Caution - if you don’t enroll when you are eligible and you don’t have other coverage, you may be penalized by paying more.
• Medicare Advantage Plan (Part C): Enrolling in a Medicare Advantage plan may be a cheaper option for many people. If you chose a Medicare Advantage plan, you opt out of Original Medicare but your Part B premium is still deducted from your Social Security check each month and many plans charge an additional premium. The advantage of enrolling in one of these plans is it takes the place of Part A (hospital coverage), Part B, and Part D and you do not need a Medigap plan. These companies must cover at least what Medicare covers but most provide additional benefits. These plans are typically less costly for healthier individuals. Unlike Original Medicare, you are not able to see any doctor or go to any facility for non-emergency care. You must see health care providers that participate with your plan. These plans and their rules can change each year so it is important that you read any information that is sent to you from your plan.
Important Information:
Click here for a list of links to our insurance partners:
Additional Helpful Resources:
Medicare open enrollment begins October 15th and ends December 7th so you have much less time to make any changes to your current plan. Let’s take a look at your options:
• Original Medicare: Many of seniors as well as those who are not 65 and have Medicare because of a disability or have End-Stage Renal Disease are covered under Part B. You pay a monthly premium that is taken out of your Social Security check each month. With Original Medicare, you can use any hospital or facility and see any physician of your choice. You have a yearly deductible that has to be met before Medicare pays (the deductible for 2011 is $162.00). Because Original Medicare only pays 80% after your deductible is met, most people cover this gap by purchasing a Medigap policy or supplemental insurance. These plans are sold by private insurance companies and they all have to follow state and Federal laws. The plans sold in NC are standardized which means that the benefits are the same regardless of the insurance company. The only difference between what companies sell is the cost!
• If you have original Medicare, you will also need to purchase a Part D (prescription drug) plan unless you have retiree benefits with drug coverage through your former employer. Companies that sell Part D coverage are all approved by Medicare. Caution - if you don’t enroll when you are eligible and you don’t have other coverage, you may be penalized by paying more.
• Medicare Advantage Plan (Part C): Enrolling in a Medicare Advantage plan may be a cheaper option for many people. If you chose a Medicare Advantage plan, you opt out of Original Medicare but your Part B premium is still deducted from your Social Security check each month and many plans charge an additional premium. The advantage of enrolling in one of these plans is it takes the place of Part A (hospital coverage), Part B, and Part D and you do not need a Medigap plan. These companies must cover at least what Medicare covers but most provide additional benefits. These plans are typically less costly for healthier individuals. Unlike Original Medicare, you are not able to see any doctor or go to any facility for non-emergency care. You must see health care providers that participate with your plan. These plans and their rules can change each year so it is important that you read any information that is sent to you from your plan.
Important Information:
- Federal regulations prohibit insurance agents from contacting you unless you have extended an invitation. There are lots of good insurance agents that will assist you in finding the right coverage for you.
- If you invite an insurance agent to your home, ask a friend or relative to be with you. Insurance is complicated and having another set of eyes and ears is helpful.
- Don’t be afraid to ask questions before you enroll with a plan. You should never feel pressured to sign.
- Don’t assume that your physician accepts the plan you want to enroll in. Call your physician and ask.
Click here for a list of links to our insurance partners:
Additional Helpful Resources:
- http://www.Medicare.gov
- http://www.medicare.gov/navigation/medicare-basics/coverage-choices.aspx
- NC Seniors Health Insurance Information (SHIIP) 800 443 9354,
http://www.ncdoi.com/shiip/default.asp