Every year. seniors on Medicare are faced with the task of examining their Medicare coverage and making important decisions. Those who think that Medicare is a one-time enrollment, which then covers everything, are truly mistaken. In fact, Medicare decisions are complex, frequent, and far reaching.
For starters, you need to know that Medicare is divided into parts. At the risk of oversimplifying:
• Part A covers costs related to hospitalization.
• Part B offers coverage for physicians and outpayment services. But Part B doesn’t cover ALL these costs,
• So you’ll need a Medicare Supplement plan, which you must chose within 6 months of signing up for Medicare because during this period you can’t be denied the most comprehensive plan (G) for medical reasons.
• Part D covers the cost of prescription drugs –but not all costs.
• And then there’s Medicare Advantage, which bundles all of the above into a “managed care” program. (See below for details on how costly Advantage plans could be if you become sick.)
Initial Enrollment If you’re retired or have no other health coverage, you should start the enrollment process in the three months before you reach your 65th birthday. But, if you’re still working, you can delay enrolling in Medicare until your retirement. Start at the government website, www.Medicare.gov.
Things get complex if you want to keep working and keep your good coverage, or if you have a spouse on your plan, or work for a small business. Then basic Medicare mistakes could impact your lifetime costs.
In these cases, I always recommend a consultation with Diane Omdahl at www.65incorporated.com before you make even the first enrollment decision. The $599 cost could save you a fortune in the future.
Medicare Supplement Sign up for your Medicare supplement at the same time you sign up for Medicare. These plans are offered in tiers, from each major private insurer. The most comprehensive is Plan G. It costs more each month, but is worth the slightly higher charge. To get help – at no cost – signing up for your supplement go to www.ehealthMedicare.com.
Medicare Drugs – Part D Even if you don’t take any prescription medicines, you should sign up for Medicare Part D immediately, and pay the small monthly charge. But if you do have prescriptions, you must review, and likely change, your coverage every year at this time. That’s because each plan changes the drugs it will cover, and the prices, and the “tiers” (percentage coverage) every year!
Just go to Medicare.gov and click on the home page link to find drug plans. Then line up your prescription bottles and input the names and correct dosage. With a click, you’ll find the plan that has the least out of pocket costs. You can sign up directly from the government website.
Medicare Advantage These days you’re seeing a lot of television commercials promising complete coverage, often with zero monthly premiums or co-pays. And some of these plans even “subsidize” your Part B premium, allowing them to promise your monthly Social Security check will increase.
Too good to be true? Ask yourself how the insurance companies get the money to pay for all those commercials offering free dental and hearing. Hint: they restrict your healthcare options, getting paid a fixed fee from the government for each member, and spending less than that on care.
Medicare Advantage plans limit you to their network of physicians and hospitals. Getting an outside consultation or services will be an additional expense to you, and may require a referral.
And, you could wind up paying a lot if you get sick — as much as $7550 in one year our of pocket on healthcare costs (or $11,300 if your plan covers some out-of-network services) in 2022. That’s likely far more than the cost of traditional Part B and supplement monthly payments. You only “win” in Medicare Advantage plans if you stay healthy!
After trying Advantage for a year, you can always switch back to traditional Medicare. But you won’t get that best supplement plan back if you have existing health issues!
The window for ALL these changes is open October 15 through December 7th. Read the changes to your existing plans, and beware of the enticing mailings. Read the fine print. These are critical decisions. And that’s The Savage Truth.