Picking the perfect Medicare plan for your health, lifestyle and budget can be overwhelming, but there are resources available to make the decisions-making process easier.
To help, MLive hosted a virtual “Guide To Medicare & Golden Retirement” event Tuesday evening, Oct. 26, featuring a panel of speakers that specialize in navigating the national health insurance program.
“Medicare can be very complex,” said Bob Callery, regional coordinator for the Area Agency on Aging of West Michigan. “It’s a lot to wrap the brain around so getting started early on, it won’t hurt you and when the time comes to make a decision on picking a plan, you’ll feel more confident”
Medicare is the U.S. health insurance program available to residents 65 and older, as well as some younger people with disabilities or end-stage renal disease. There are different types of plans available, ranging in cost and coverage.
Below are five takeaways from Tuesday’s event. Full video of the session is available through MLive’s YouTube account, here.
1. What are the types of plans?
Original Medicare plans, also known as Traditional Medicare, can be broken down into Part A (hospital insurance), Part B (medical insurance), and Part D (prescription drugs), with a bonus option of supplemental coverage to pick-up services not covered by the aforementioned parts.
Then there are Medicare Advantage plans, which are sometimes referred to as Part C. They combine Part A and Part B, and are provided by private insurance companies approved by Medicare. Individuals who get a Medicare Advantage plan will still want to have a prescription drug plan, though many of these bundled plans include Part D, along with additional benefits like vision, hearing and dental services.
2. When can I sign up for Medicare?
Residents typically become eligible for Medicare three months before they turn 65, with the initial enrollment period lasting three months after their birthday. Most people at least sign up for Part A and Part B plans when they’re first eligible.
Additionally, there is an annual open enrollment period, during which you can join, switch or drop a plan. The 2021 open enrollment period is Oct. 15 through Dec. 7, and any coverage changes made during that time will kick in Jan. 1.
3. What should you consider when choosing a plan?
Jennifer Kivi, senior market product manager for Priority Health, recommends putting together a list of your doctors and medications, including how often you seek care, to use as a reference when you are determining which plan is right for you.
It’s also important to consider which “extra” coverage is important to you, including dental, vision, hearing, gym memberships, and over-the-counter allowances that might be available under a Medicare Advantage plan, but not a traditional Medicare plan.
4. What types of penalties should you watch out for?
Choosing to skip some types of coverage plans during your initial enrollment period can lead to financial penalties if you don’t have credible coverage from another avenue, like your employer’s health plan.
For example, if you go without Part B coverage, you can accrue a 10% penalty for each year that you’re uncovered. That is added to your premium and becomes a lifelong penalty.
You can also be responsible for a 1% penalty for every month you go without a prescription drug plan. So it’s important to understand what coverage you already have when signing up for Medicare, and what coverage you need to select to avoid penalties.
5. What resources are available to help in picking your Medicare plan?
There are many resources available to assist you in choosing the right plan for you.
The state offers free and unbiased assistance in reviewing and comparing plans through its Michigan Medicare/Medicaid Assistance Program (MIMAP) at 800-803-7174 or through its website at mmapinc.org.
Senior centers and hospitals often have trained staff to assist you, or you can contact your local area agency on aging. For help selecting your Part D drug plan, you can reach out to your local independent pharmacist.
You can also visit https://www.medicare.gov/ or call Medicare’s toll-free assistance line at 1-800-633-4227.
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