Medicare’s Annual Open Enrollment period begins soon. During this time Medicare beneficiaries can change their medical costs, their doctors and prescription coverage. For many older adults the process can be challenging.
Dr. Todd Wisser, Internal Medicine Physician with New West Physicians, part of Optum, provides the following tips for older adults and their caregivers:
Q: How do I get Medicare coverage?
A: You can choose Original Medicare (Parts A and B). Part A is hospital coverage and Part B is medical coverage. Coverage is provided by the federal government.
You can also get benefits through a Medicare Advantage plan (called Part C). Medicare Advantage plans combine Part A and Part B coverage. Many plans also include prescription drug coverage (Part D) and offer benefits not provided by Original Medicare. Plans are offered by private insurance companies approved by Medicare.
There’s also Medicare supplement plans. These plans cover some of what Medicare Parts A and B don’t pay, such as portions of coinsurance, copayments and deductibles.
Q: What are some of the things I should think about when choosing coverage?
A: Ask yourself these questions to guide your decisions:
- How often do you visit the doctor?
- What prescription medications do you regularly take?
- Do you have a particular doctor, hospital or pharmacy that you want to use?
- Do you have retirement health coverage?
- Would you rather pay less in monthly premiums or pay less out of pocket when you receive health care?
Q: What is the best way to get information to make smart decisions during open enrollment?
A: Before you consider your enrollment options, make sure that the care provider network that you choose includes the doctors you prefer to see. If you like your doctors, confirm that they will be in the care provider network for the health plan you choose.
You can visit the Center for Medicare & Medicaid Services website at www.medicare.gov; call 1-800-MEDICARE,(available 24/7); or contact Medicare Advantage health plans directly. You can find more information at www.MedicareMadeClear.com.
Another good resource is an independent licensed insurance agent or health plan sales agent. They help Medicare beneficiaries learn about benefit options, what's going to fit their needs and how they can continue to see their preferred doctors. They can explain health plans that have programs for chronic conditions or cover alternative medicine.
Q: Why is the topic of health care planning so stressful?
A: Health care is an important decision. It can be stressful for caregivers –because they don’t want to make a decision that will hurt the Medicare beneficiary.
Ultimately, the worst response is no decision, when someone may say, “Well, I won't make a choice, I'll leave everything as-is because I'm comfortable with that.” The more you know and the sooner you know it, you can do your research and then decide.
Don’t wait until the last minute. Start early and give yourself the time you need to make the decisions that will be right for you.
When you are ready to make your choice, call 1-866-964-1547, TTY 711, Monday through Friday, 8 a.m. to 5 p.m.
Optum Disclosure: Calling these numbers may direct you to a licensed insurance agent.