The Medicare Annual Enrollment period allows qualifying individuals to enroll in Medicare or make changes to their existing plans. The federal health insurance program is for people 65 and older or people who have a qualifying disability.
Original Medicare consists of two parts. Part A covers hospital and inpatient services, and qualifying individuals are automatically enrolled. If they or their spouse worked and paid social security taxes for ten years, they will not have to pay a premium.
Medicare Part B covers outpatient services, and it is optional. Individuals are automatically enrolled in Medicare Part B if they receive Social Security retirement benefits. If not, they must file with Social Security. Under this health plan, a patient will pay for services to meet a $233 deductible, and then they will have 20% co-insurance.
Medicare Part A and Part B do not cover dental, vision, or prescription drugs. People have the option to add more coverage by choosing a Medicare Advantage Plan (Part C) through a private company that is contracted with Medicare.
Cheri Murray is a Licensed Medicare Advisor at Geisinger.
“Everybody’s needs and wants are different,” she said. “So we like to review the cost associated with medications, we look at the typical services that someone might use in their typical year, and then of course we discuss what the differences are between Medicare, having a secondary or a Medicare Advantage Plan.”
Medicare Advantage Plans offer a complete package for an individual’s health care needs. Secondary plans, or Part D, allows people to stick with original Medicare and add a supplemental plan, also known as Medigap coverage. Private insurance companies have plans that help fill in the gaps in Part A and Part B, including prescription drug costs.
Linda Rowe is a Medicare Sales Manager for Geisinger Health Plan. The advisors meet with people one on one to educate them on the plans available to them and what is best for their needs. Those needs could include the health services they anticipate, doctors they want to see, and medications they take.
“People are often afraid, especially when they’re retiring and they’re used to being on an employer’s plan, that the comfort and safety of what their employer chose for them is now leaving them to go out and choose for themselves,” she said. “We can put people on the right path.”
Recipients of original Medicare can see any health care provider that accepts Medicare. Medicare Advantage Plans offer coverage to doctors in their network only.
Murray says insurers can provide a list of the doctors they are contracted with and medications that are covered with each plan. She encourages people who are already enrolled to consider if their needs have changed.
“Look at the plans and purchase the plans that best suit your needs at the time, because you can switch them year after year after year, during those open windows.”
The Medicare Annual Enrollment period runs from October 15th to December 7th. Individuals are eligible 3 months before turning 65, or earlier if they have a qualifying disability.
