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Addressing Medicare Confusion

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Whether you are caring for someone on Medicare, or you have been on it for years, there can be a lot of confusion during the annual renewal process, which is always October 15^th to December 7^th.  If you have an employer-sponsored plan, your dates may vary.

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What are the parts that make up Medicare?

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1. At age 65, you become eligible for Medicare, Parts A&B. You DO have to enroll to get it and the fee for 2023 is $164.90.  It can be paid monthly or quarterly, or can be deducted from your social security deposit.

     Parts A&B cover 80% of allowable doctor and hospital charges.

2. You have also (optionally) either elected Medicare Advantage or a Medicare supplemental plan.

Medicare Advantage covers 20% of allowable doctor and hospital charges not covered by part A&B.  It often covers prescription drugs as well.  There are co-pays associated with it.  It may cover vision, dental, hearing as well.

 Supplemental Plan (F-Z) also covers 20% of allowable doctor and hospital charges not covered by part A&B.  Drug coverage is not included, nor are there co-pays, which can add up.

3. Part D is the prescription drug plan, also optional, but you pay a penalty if you decide to add it later in life.

4. Dental, Vision, Hearing Coverage. Some people have an additional policy for this.

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What should I look for each year and what can be changed?

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1. Part A/B coverage is for most everyone and only the rate will change.
2. It can be difficult, if not impossible, to change your Advantage or Supplemental  plan or switch between them once you have pre-existing conditions.
3. Part D is the part that you should look at carefully each year for savings.  It is easy to change.
4. A Dental/Vision/Hearing plan can also be changed but takes a bit more work.

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How to make changes

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Drug Plans

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Changing a prescription drug plan is easy if you are comfortable online.  If not, calling a broker or using state services will be simpler.

• Have a list of your medications, dosage and frequency ready
• Medicare.gov has a great website for finding the cheapest plan for the drugs you take and your location. Go to “Health & Drug Plans” at the top.  It is very simple if you have a Medicare.gov account because they will have your previous medications already.
• Sometimes changing your pharmacy or using mail order can save you a lot!

Most states have a free resource (SHIP or other name) with staffers who can help you choose a plan. 

And we help our clients with this. 

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Dental Plans (Etc.)

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This article from the American Association of Medicare Supplement Insurance tells you what to consider & has some links to help you.

We hope this clears up a few things for you.  As always, if you have questions you know where to find us!

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