BY RANDAL C. HILL
Ah, autumn. A time for football games, Oktoberfests and shopping. Not for
gifts—that time arrives soon enough—but for securing the best possible
deals during the Medicare Open Enrollment period. This is your opportunity to use Medicare’s Plan Finder (www.Medicare.gov/find-a-plan) to find a program that
best meets your needs.
The Medicare Open Enrollment Period is one of the most confusing and
misunderstood annual events in this vital program. Premiums, benefits, formulary,
copays, provider and pharmacy networks can all change—and often do from year
to year. Give yourself plenty of time to review and understand your options, and
don’t be afraid to seek help. Both Medicare and Medicare Advantage plans have
licensed agents to guide you, and your state health insurance agency also has
counselors who can help you sift through the often confusing information.
This includes Part A (which covers certain hospital expenses) and Part B
(which applies to doctor bills and other medical costs). That’s it. Period. No dental
care. No vision coverage. No hearing aids. Medigap plans (also known as Medicare
Supplement plans) can be purchased to provide coverage for these gaps.
Parts C and D
Though Medicare offers a valuable healthcare safety net, most of us want
to create a custom plan that fits our particular needs. This is where Medicare
Advantage plans (Part C) come in. These are private insurance options run by
government-regulated insurance companies for seniors and the disabled currently
enrolled in Original Medicare (Plan A and Plan B). Out-of-pocket costs in Part
C plans can sometimes be lower than with Original Medicare and often include
benefits not found in Parts A and B. Prices vary by plan provider, so it’s to your
advantage to compare all the plans available in your area before choosing the one
best for you.
Most Medicare Advantage plans also include prescription drug coverage,
which is an optional add-on called Part D, for beneficiaries who retain Original
Medicare. Luckily, premiums are not influenced by age or preexisting conditions.
You can usually enroll if you live in the service area of the plan you want to
join, you have Original Medicare and you don’t have end-stage renal disease.
Phone a friend
To help you navigate your way through the often-daunting mountains
of information, Medicare has licensed insurance agents at 1-844-847-2659
(TTY users 711) Monday through Friday 8 a.m. to 8 p.m.
Have a list of prepared questions at hand when you call.
Dates to remember
Like anniversaries or birthdays, you can be in big trouble if you forget
them. Mark the following dates on your calendars:
• October 15 – This is when Open Enrollment begins. You can now switch
Medicare plans, join a Medicare Prescription Drug Plan or drop your
Medicare Prescription Drug Plan completely.
• December 7 – In most cases, this is the last day to change your Medicare
coverage for the next year.
• January 1 – Your old or new coverage starts today. If you are satisfied with
your current coverage, you don’t need to do anything.
Special Enrollment Periods (SEPs)
These offer a lifeline for certain unexpected life changes and are opportunities
for change in addition to the regular annual enrollment periods. Go online or call
Medicare for more information on this program.
The Sunshine State scenario – good stuff to know
In 2018, Medicare offers 295 Medicare Advantage plans to Floridians. These
plans are available to all with Medicare. There are 21 Medicare prescription drug
plans offered; 84 percent of people with a Medicare prescription drug plan have
access to a plan with a lower premium than they paid in 2017. Also, 29 percent of
people with a Medicare prescription drug plan can get Extra Help, also called the
low-income subsidy, or LIS. Visit www.socialsecurity.gov/i1020 to apply online,
or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and ask for Form
Three helpful hints:
Review your most recent Medicare and You handbook to see a listing of the
plans in your area. Make sure to carefully read your “Annual Notice of Change”
letter. Get free personalized health insurance counseling by calling your State
Health Insurance Assistance Program (SHIP) at 1-800-96 ELDER (1-800-963-
5337); TTY call 1-800-955-8770. You can also visit www.floridashine.org
For everything else…
Visit www.medicare.gov online or call 1-800-MEDICARE (1-800-633-4227);
(TTY 1-877-486-2048). It’s worth the wait (and enduring the “on hold” music) to
get the important information for your 2019 medical needs.