By TERRI BRYCE REEVES, Editor
October brings Medicare Open Enrollment, an annual opportunity to compare, review and enroll in Medicare health and drug plans. This year, open enrollment begins October 15 and ends December 7.
Coverage begins January 1, 2018.
Understanding Medicare Part A, B, C and D and sorting out the differences between original Medicare, Medicare Advantage and Medicare Supplement plans
is key to making the right choice. So let’s dive in the alphabet soup and see what the government and private insurance companies have to offer.
Original Medicare consists of Parts A and B.
• Medicare Part A covers inpatient care in hospitals,
short-term care in a skilled nursing facility and hospice
care. It will also cover some home health costs during
recovery, but generally doesn’t cover long-term care.
(Often there is no premium but deductibles and coinsurance
• Medicare Part B covers outpatient services like
doctors’ visits, labs and X-rays; medical equipment
and supplies; ambulance and preventative services.
Usually there is a premium for Part B. The co-pay
is normally 20 percent after
you’ve reached a deductible
and there is no out-of-pocket
annual maximum limit.
Medicare Part C, also known as Medicare Advantage plans, are Medicare replacement plans sponsored by private companies that have contracted with
Medicare. These plans
must provide at the least as much coverage as
original Medicare and
often deliver more. They bundle hospital stays, doctors’ visits and other services; most provide prescription drug coverage. Some include vision, dental and other
coverages not covered by Medicare. They usually cap out-of-pocket expenses and their premiums are normally lower than Medicare Supplement plans. They usually have co-pays and deductibles.
Medicare Part D is prescription coverage run by
Medicare-approved private insurance companies.
Those who have original Medicare or a Medicare
Supplement plan, should consider purchasing Part D
separately to cover drug costs.
Each drug plan has its own list of covered drugs
(formularies) placed into different “tiers” according
Medicare Supplement Insurance, or a Medigap
policy, is sold by private companies to fill the “gaps”
that original Medicare doesn’t cover, like copayments,
coinsurance, and deductibles.
Some Medigap policies offer coverage for services
that original Medicare doesn’t cover, like medical care
when traveling outside the U.S.
Please note, Medigap policies sold after January
1, 2006 aren’t allowed to include prescription drug
coverage so you must join a Part D plan if you want
prescription drugs covered. Also, Medigap policies
generally don’t cover vision or dental care.
HELP IS HERE:
SHINE (Serving Health Insurance Needs
of Elders) is a free program offered by the Florida
Department of Elder Affairs and your local
Area Agency on Aging. Specially-trained volunteers
can assist you with your Medicare, Medicaid
and health insurance questions by providing
one-on-one counseling and information. SHINE
services are free, unbiased, and confidential.
Medicare can help you enroll. If you’re satisfied
that your current coverage will meet your needs for
next year, you don’t need to do anything. To compare
plans visit Medicare.gov/find-a-plan and use the
Medicare Plan Finder. By phone, call 1-800-MEDICARE
(1-800-633-4227), and say “Agent.” TTY users
should call 1-877-486-2048. Help is available 24
hours a day, including weekends.
Do you need “Extra Help” paying for Medicare prescription drug coverage? If you have limited income and resources, you may qualify for “Extra Help” to pay your prescription drug costs.
Visit socialsecurity.gov/i1020 to apply online. Or, call Social Security at
1-800-772-1213 and ask for Form SSA-i1020. TTY users should call