Addressing Medicare Confusion
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 15th to December 7th. If you have an employer-sponsored plan, your dates may vary.
What are the parts that make up Medicare?
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.
What should I look for each year and what can be changed?
- Part A/B coverage is for most everyone and only the rate will change.
- It can be difficult, if not impossible, to change your Advantage or Supplemental plan or switch between them once you have pre-existing conditions.
- Part D is the part that you should look at carefully each year for savings. It is easy to change.
- A Dental/Vision/Hearing plan can also be changed but takes a bit more work.
How to make changes
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.
Dental Plans (Etc.)
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!