If you are one of the 44 million individuals throughout the United States enrolled and eligible for Medicare, you’ve probably been bombarded with direct mail, TV commercials, radio spots and digital ads about the enrollment period throughout the last month and a half. In any year but this year, there would also be various in-person seminars and learning sessions to help review the options and processes. Instead, many have been held virtually this year.
But if the ‘call to action’ messages from those ads or seminars haven’t gotten you to take that action just yet, be sure you do so now! The Medicare enrollment period ends in just days – and you still have a chance to determine if the coverage you have is what you need!
If 2020 has shown us anything, it has emphasized the importance of good health. Ensuring you have the coverage you need to help cover the costs of any services, procedures, prescriptions and more in the New Year is worth the effort. Fortunately, there’s an abundance of information available online to help guide that process. Alternatively, you can turn to an unbiased, licensed health insurance agent to provide an overview of options, pricing and details.
However you choose to take on the enrollment process, keep the following information in mind.
The Four Parts of Medicare
As we all have different health needs, Medicare is broken down into four parts – or ‘options,’ if you will – to accommodate different needs and budgets.
Medicare Part A – also known as ‘Original Medicare’ – is free of charge as a result of the Medicare taxes you pay while working. In-patient hospitalizations, hospice care, home health care and some nursing home care are some of the services covered by Medicare Part A.
Medicare Part B covers doctor visits, outpatient services and more and requires a monthly premium payment. Those enrolled in Medicare Part B also have to pay a deductible and once the deductible is met, they have to typically pay approximately 20 percent of covered services.
Medicare Part C refers to Medicare Advantage plans, which involve private insurance companies that work on behalf of Medicare. These plans often include prescription plans (Medicare Part D) and the monthly premiums are typically less expensive.
Medicare Part D is the prescription plan, which is important for so many to consider. Like Part C, these plans are contracted through private insurance companies.
In terms of what to consider with these four different parts of Medicare, it really comes down to each individual’s unique situation. You may have a certain primary care physician you want to see and not worry about those in or out of network. Alternatively, perhaps you travel often (in a non-pandemic time!) and in the event of a medical emergency, you would want to see any hospital, doctor or provider that accepts Medicare. Whatever your situation may be, be sure to do all your research or consult with an unbiased, licensed agent to determine your best option.
Other Important Considerations
Make sure you confirm which doctors and hospitals are in a plan’s network. If you have specific physicians or healthcare facilities you frequently use – even if virtually during these times – make sure you determine whether or not they are included in the plans you review. Additionally, make sure any prescriptions you take are accounted and budgeted for within your plan.
Additionally, you may want to look into Medigap, which is a supplemental policy often paired with Medicare Parts A & B that can help mitigate copays and deductibles that would otherwise be paid out of pocket.
Depending on your annual income, you may be eligible for Medicaid and/or the Low Income Subsidy (LIS) program, which is a component of Medicaid to assist with the cost of prescription drugs. Eligibility varies by state and generally determined by Social Security Income, so again, it’s important to consult with a professional to understand whether or not you may qualify and what your next steps should be.
There’s a lot of information out there and while it’s important to do your best to understand what you need in terms of coverage and budget, you can also turn to a professional to help guide you through the process and ensure you have the best plans to meet your health and budget needs.