Understanding Medicare Before Open Enrollment Period

Understanding Medicare Before Open Enrollment Period

Thumbnail image from Pixabay

By Daniel Short of Simply Seniors

Day after day, we learn about readers who have been mislead about Medicare and how it works. They have been convinced they needed to buy things that were not in their best interest.

To combat this, we have decided one of the best ways to help you in Living the Good Life, is to make sure you received fair and accurate information about Medicare, how it works and how these options affect you. We will give you the facts, then give you some real-world examples of how this relates.

Our hope is that through this you will be armed with the information you need to make educated decisions for you and your family during the next enrollment period.

An explanation of Medicare parts
An explanation of Medicare parts. From Coverance.com

Where to start with understanding Medicare?

We are going to start with understanding the difference between traditional health insurance and managed healthcare plans.

Let’s think back to the good ol’ days. Remember when you never worried about having to pick a doctor? You usually had a doctor your family had used for many years. There were one or two hospitals in town. Nobody told you what doctor you could see, or what hospital you had to go to.

Our employer usually provided health insurance as part of our benefits for us and our families.

We remember the days when we would have children and there was very little, if any cost. We never worried about how much it would cost us if we had to get medical help.

This was how we all understood health insurance to be. Go to any doctor, any hospital, and the costs were covered for you. This is traditional health insurance.

Then, one day, in the 1980s and 90s we started hearing all these new words like, HMO, PPO, network, co-pay, out-of-pocket expenses and referrals. People told us how great it was going to be. That we could see one of their few doctors, or go to one of their two hospitals and pay a few bucks here and there as we needed care.

Suddenly, “preferred” doctors were limited. From Pixabay

Suddenly, we had limited doctors we could see. And we started to consider the cost of seeing a doctor as to if we were going to get treatment. This is managed healthcare.

I have asked thousands of people which of these programs they would choose if they had the choice: traditional health insurance where they could see any doctor, go to any hospital, and have all their costs covered, or managed healthcare where they could see some doctors, go to some hospitals and pay extra costs as they go. It is no surprise that every person that looks at this option chooses traditional health insurance: Any doctor, any hospital, all costs covered.

The truth is that within Medicare, you have this same choice! You can choose traditional health insurance, or managed healthcare.

And, you can make this choice at more times than just during the annual election period October 15 through December 7 each year. If you have chosen a Medicare managed healthcare plan, there is a special window called Medicare Advantage open enrollment period each year from January 1 through March 31 where you can move to Medicare traditional health insurance, also known as Original Medicare, or switch Medicare Part C plans.

Choosing and signing up for Medicare can be a bit intimidating whether it’s your first time or another open enrollment period. have no fear when it comes to choosing the insurance plan that works best for you and your family. Know the open enrollment periods in which you are able to re-evaluate your healthcare coverage and needs in order to keep your body and wallet healthy.


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