It’s open enrollment season; here’s a primer in finding the right Medicare answers for you
If picking a Medicare plan makes you panic, you’re not alone.
Most people avoid the whole thing as long as possible, but “it’s not as scary as it seems,” said Jim Murphy, a Statewide Health Insurance Benefits Advisors volunteer in Moscow who offers free advice about health insurance to senior adults.
With enrollment currently open for Medicare parts C and D, now is the time for many seniors to take some decisive action. And thanks to volunteer advisers, it’s not something you have to figure out on your own.
Murphy offered this basic information about Medicare, the current open enrollment season and help that is available for those seeking to enroll:
Q: What are the different parts of Medicare?
A: Medicare is broken into four main parts:
Medicare Part A is hospital insurance that covers inpatient stays and is free or very low cost.
Medicare Part B is medical insurance that covers doctors’ services, diagnostic and preventive care. This low-cost insurance generally covers 80 percent of the fees.
Medicare Part C, also called Medicare Advantage Plans, are offered by private companies that contract with Medicare to provide coverage. This can include dental and vision coverage.
Medicare Part D is prescription drug insurance provided through private companies.
Additionally, Medicare supplemental insurance, also called Medigap, is offered by private insurers and helps to cover costs not covered by other parts of Medicare, for example, the 20 percent not covered by Medicare Part B. For more information visit www.medicare.gov.
Q: When do I enroll for Medicare?
A: It depends. People younger than 65 who are already receiving Social Security or railroad retirement benefits will be automatically enrolled in Medicare parts A and B when they turn 65.
Anyone using Medicaid will get Medicare for free (Medicaid pays the Medicare premium), plus extra help to assist with Part D.
Most people enroll in Medicare around age 65, during a seven-month window called the Initial Enrollment Period that begins three months prior to the month of their birthday and continues through their birthday month and the three months following. Some people are automatically enrolled for Medicare parts A and/or B, and some must enroll manually. Advisers can help individuals determine if they need to enroll.
A person can also enroll during the General Enrollment Period from Jan. 1 to March 31, but there can be late-enrollment penalties for not signing up for Medicare when you are first eligible. If a person has health coverage through their employer or spouse’s employer, however, they can delay Medicare Part B enrollment without penalty by enrolling during the General Enrollment Period or an eight-month Special Enrollment Period that begins the month the employment or health coverage ends.
Q: How do I enroll for Medicare?
A: There are three ways to enroll for Medicare parts A and/or B. You can visit your local social security office, call (800) 772-1213 or go online to www.socialsecurity.gov.
Q: Am I required to enroll in Medicare?
A: No. However, if you do not enroll when you are first eligible, you may have to pay higher premiums as a penalty when you enroll later.
Q: What is the purpose of the current open enrollment season?
A: The current enrollment season allows those with Medicare to enroll in or make changes to Medicare parts C or D without penalty. The enrollment window runs from Oct. 15 to Dec. 7.
More information about enrolling in other parts of Medicare is available by talking to a SHIBA volunteer advisor or visiting www.medicare.gov.
Q: Why might I want to get help selecting a Medicare Plan D or Medicare Advantage Plan?
A: There are many Medicare Part D plans to choose from, and a person’s prescription drug needs are highly personalized.
The number of prescriptions people take and where they buy them will influence how much their Medicare Part D coverage will cost. For example, there are 25 Medicare Part D plans available for Latah County residents. Some may benefit from a more expensive plan that covers a larger percentage of drug costs, while another would not benefit from the same plan. Likewise, Medicare Advantage Plans vary significantly in cost and coverage, and many people benefit from personalized advice.
Q: How do I get help selecting a Medicare Plan D or Medicare Advantage Plan?
A: Each state provides advisors to help people select Medicare plans that are best for them.
In Idaho and Washington, this free service is offered by SHIBA.
The advisers are primarily volunteers who are certified after training each year to help people understand what their options are and the best way to get health care coverage. They don’t sell insurance or recommend one company or agent over another, but they provide unbiased and confidential help in determining options.
Q: How do I meet with a volunteer advisor?
A: You’ll want to meet with an adviser that specializes in the options available in your county. Someone in Whitman county, for example, is able to access a list of options in Asotin county, but will not be as familiar with them. To find a volunteer adviser in your area and make an appointment, see the accompanying information in “Free Medicare open enrollment help” or call the state office: (800) 562-6900 in Washington and (800) 247-4422 in Idaho.
Q: What should I bring to the appointment?
A: Bring your Medicare card, along with a list of your medications and dosages. If you aren’t currently enrolled in Medicare, do that first, as it will take a few weeks to receive your Medicare card.
Original Date: Nov 5 2018