Medicare open enrollment starts soon – Chicago Tribune
Are you considering changing your Medicare coverage? Between October 15 and December 7, the open enrollment period for Medicare, you have the opportunity to change your coverage without penalty.
There are many resources to help you determine whether it pays for you to use traditional Medicare or rather to use a Medicare Advantage plan.
Whether you are new to Medicare, or are confused about your options, I recommend that you obtain “Get What’s Yours for Medicare” (Simon and Schuster) by Philip Moeller.
Moeller helpfully summarizes the types of Medicare Advantages (MA) plans, specifically health maintenance organizations (HMOs), preferred provider organizations (PPOs) and private fee-for-service (PFFS) plans.
HMOs generally require that you receive all your care in their network. To use services outside the network carries high costs. Your primary physician coordinates your care and handles any referrals you require. This type of MA plan is generally the cheapest, and it includes Part D (prescription drug) coverage. The cost is in addition to the part B premium which for 2017 is $134 per month for most beneficiaries.
A point-of-service plan is an HMO that provides some out-of-network access and includes some price protection for out-of-pocket costs.
A PPO offers you a wider access than an HMO to doctors and hospitals outside its network. Generally, you don’t need referrals from your primary doctor. However, this feature will result in higher premiums and more out-of-network costs. There are two types of annual limits: one for in-network and one for out-of-network care. Part D can be bundled with the plan.
The U.S. government’s Medicare website (www.medicare.gov) provides you access to a Medicare plan finder, an excellent resource. If you enter your Medicare number and prescription drugs/dosage, you will be provided a list of possible health care options in your geographic area, cost information and customer-satisfaction ratings.
Another good resource is the State Health Insurance Assistance Program (SHIP). Each state has one of these nonprofit organizations to provide, at no cost to you, information about Medicare eligibility issues and advice about problems you may have with the program. I volunteered for a local SHIP office for many years, and I found the staff to be knowledgeable and very helpful to callers. If you volunteer for SHIP, you will become well educated in the nuances of health insurance issues.
If you are already enrolled in a Medicare plan, or Part D, you should receive an “Annual Notice of Changes” and “Evidence of Coverage.” You should review these documents in order to determine the impact of projected changes to your costs for 2018. If you are dissatisfied with your current coverage, you can go to the Medicare plan finder to determine if there are better options for you.
Another excellent source of information is a government-issued handbook, “Medicare and You 2018.” If you are currently enrolled in Medicare, you should have already received this document, which covers all the basic information about Medicare, including enrollment information, what is covered under Part A (hospital insurance), Part B (medical insurance) and Part D (prescription drug), as well as associated costs. Medicare Advantage Plans and Medicare Supplement Insurance are explained. Medicare Part B only covers 80 percent of medical expenses. If you use Medicare supplement insurance, you can have the remaining 20 percent covered. If you haven’t received this book, call 800-633-4227.
Another excellent source for Medicare information is “Social Security: The Inside Story,” self-published by Andy Landis (www.andylandis.biz). Landis devotes 50 pages of his book to Medicare and includes a comprehensive list of useful Medicare sources. I have found his book to be one of the best guides Social Security regulations. The book is well-organized, comprehensive and easy to understand, and it contains relevant references.
(Elliot Raphaelson welcomes your questions and comments at firstname.lastname@example.org.)
(c) 2017 ELLIOT RAPHAELSON. DISTRIBUTED BY TRIBUNE CONTENT AGENCY, LLC.