I find Medicare and Medicare Open Enrollment to be very confusing. Do you? Let’s spend the next two weeks trying to better understand your options and guide you through the Open Enrollment process. I highly encourage you to delay your final decisions until we walk through this process and you compare your options.
The first big decision is which TYPE of insurance coverage is best for you.
Main TYPES of insurance coverage options over age 65
Original Medicare – When you turn 65 and meet eligibility criteria (use this link), you can have Medicare Part A, Medicare Part B, and Medicare Part D. Medicare has a list of items they do and do not cover at this link. Medicare covers part of the expenses, and you pay the rest through your copay and deductible.
- Part A covers hospital, long term care, home care, hospice, lab tests, and surgery.
- Part B covers doctor visits, other healthcare provider visits, outpatient care, durable medical equipment, some prevention, and home health care.
- Part D covers medicines.
Medigap – This is a supplemental insurance to go with your Medicare Part A and Medicare Part B. Medigap will cover some of the copayments, coinsurance, and deductible expenses not covered by original Medicare. You purchase a Medigap policy through a private insurance company. You will pay a monthly premium for this co-insurance.
Medicare SELECT – Medicare SELECT is a managed care version of Medigap. It is the health maintenance organization (HMO) of Medigap plans. These plans contract with specific provider groups for a lower fee. So, they are typically less expensive. Be sure your provider or a provider with whom you are comfortable is participating before you select this type of plan.
Medicare Advantage – This is also known as ‘Medicare Part C’. Medicare Advantage plans are private insurance plans that you can select IN PLACE OF Medicare. They have similar coverage to Original Medicare and can have additional benefits as well. These have a wide range of prices.
A Medicare Medical Savings Account Plan is a high deductible Medicare Advantage Plan with a bank account. The plan puts money from Medicare into the account, and you use that money to pay for Medicare-covered expenses. This limits your out-of-pocket expenses to meet your deductible.
NOTE: you cannot have both a Medigap and a Medicare Advantage plan. You can have one or the other.
Other – You might have insurance through your former employer, insurance through special programs, Tricare, Veteran’s benefits, Indian Health Service plans, or other unique plans.
Medicare resources to help you
The Medicare website has a list of eight questions to consider when you are thinking about changing plans. You can find them at this link.
Next week we will talk about the tool(s) available to you to help you compare your plan options. These will let you predict your costs over the next year. You can compare several aspects of the types of plans you want to consider. I encourage you to compare your options before making your final decision. I’ll walk you through it step by step.
For more information about your Medicare options, contact us at www.medsmash.com/contact. If we can’t answer, we have some colleagues who are experts in the field.
Medicare is not the only area of life where there can be a lot of confusing messages. I have teens. I know just a few of their areas of confusing message are:
- What to wear
- How to act
Many of my recent pharmacy students are working their way through messages about:
- What job to choose
- How much of their income to spend on houses, cars, vacations
- When to start a family; or whether to start a family
Many of my peers are sorting through messages about:
- Helping children with college and career decisions
- How much independence to allow teen children
- Preparing for empty nest and soon retirement
My patients are working through message about:
- Living at home vs. a senior living community
- Options to move in with children when assistance is needed
- Activities that enhance quality of life and keep them active
And we know there are countless people struggling with even more life-altering decisions surrounded my many confusing messages.
So, where does the truth reside?
John 14:6 NIV
Jesus answered, “I am the way and the truth and the life. No one comes to the Father except through me.
Psalm 145:18 ESV
The Lord is near to all who call on him, to all who call on him in truth.
Not to sound too pious, God is with you always. Whether you ‘feel’ His presence or not, He’s there…with you…always! When the messages from the many sources are confusing, you can just ask.
Matthew 7:7-8 ESV
“Ask, and it will be given to you; seek, and you will find; knock, and it will be opened to you. For everyone who asks receives, and the one who seeks finds, and to the one who knocks it will be opened.
When the messages are all confusing, ASK!