Medicare Open Enrollment

By: Karin Pauly

October 15 through December 7th

It is that time of year again – and whether you need to enroll yourself or for a care receiver, it is never a bad idea to brush up on terminology, to understand what is available and the changes to the Medicare programs and plans.

Here are some fantastic resources to help you through your Medicare enrollment process:

• The official Medicare website https://www.medicare.gov/ is loaded with information including a preview of the 2020 plans at https://www.medicare.gov/plan-compare/#/?lang=en.
• My favorite resource is the “Medicare and You” handbook, which is downloadable at https://www.medicare.gov/Pubs/pdf/10050-Medicare-and-You.pdf. It covers how to enroll, highlights the plans (Part A, Part B, and Part D), and explains the differences in original Medicare and Medicare Advantage programs. 
• You may call Medicare directly at 1-800-MEDICARE for general questions.
• AARP has done a nice job of outlining expanded benefits coming to Medicare Advantage plans in 2020 at https://www.aarp.org/health/medicare-insurance/info-2019/medicare-advantage-expanded-benefits.html
• There are insurance agents with expertise in Medicare programs who can provide you more personalized service. They may educate you on the benefits and coverage of the various programs and help you select a plan that is right for you or your loved one.

Terminology and Things to Remember:

• Medicare is our nation’s health insurance program for people 65 years or older and for some younger than 65 with certain disabilities or chronic illnesses. 
• Original Medicare includes Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). If you want drug coverage – Part D, you may join a separate plan as well. You can use any doctor or hospital in the U.S. that takes Medicare.
• Medicare Advantage (also known as Part C) is an all-in-one alternative to Original Medicare which includes Part A, Part B, and typically Part D. In most situations, you will need to use doctors within the plan’s network. Most plans offer benefits that Original Medicare does not cover. These plans may have lower out-of-pocket costs. 
• Remember, Medicare plans have deductibles and out-of-pocket expenses, so it is important you understand the difference among the plans. Know that with Original Medicare, you may purchase supplemental coverage such as a Medigap policy to help pay for out-of-pocket expenses. With Medicare Advantage you cannot buy or use a supplemental policy.
• Original Medicare typically does not cover care outside of the U.S., so if the care receiver is a traveler, a Medigap policy to cover care outside of the U.S. might be a good idea. Also, some Medicare Advantage plans do not cover care outside of the U.S.
• October 15-December 7th is the enrollment period for 2020 coverage which will begin on January 1 if the enrollment information is received on or before December 7th.
• There are services NOT covered under Original Medicare, which include most dental care, dentures, eye exams related to prescription glasses, hearing aids and long-term care.
• Long-term care includes non-medical care for people with a long-term illness and disability. Examples include assistance with activities of daily living such as dressing, bathing, using the bathroom, cooking, feeding, adult day care, and more. Medicaid, which is state run, may be an option if eligible or you may purchase long-term care insurance to off-set these expenses.

Sources:

• AARP.org
• Medicare.gov