It’s officially fall: the season of cozy sweaters, blistery walks, and Medicare Open Enrollment! Here is what is new for 2020 and what to consider when reviewing plans.
The Open Enrollment Period begins on October 15th and ends on December 7th. Whether you are a new enrollee or currently enrolled in a Medicare plan, the Open Enrollment Period is your opportunity to revisit your choice of Medicare plans. You can stay with your current plan or change plans.
Most enrollees participate in one of these basic plans:
- Medicare Part A (which covers in-patient/hospital)
- Medicare Part B (which covers out-patient/medical)
- Medicare Part C aka Medicare Advantage Plan – an “HMO” type plan providing Part A, Part B, Part D and a menu of additional services (such as eye care, dental, etc.)
- Medicare Part D (covers drug plan)
Here is what to consider when reviewing your current plan:
Financial: Is saving money your priority?
- The average monthly premium charged for a Medicare Advantage Plan (Part C) is lower than that of traditional Medicare (Parts A and B) plans.
- Many Medicare Advantage Plans have a $0 premium, but be sure to check their 2021 premium charge and other out-of-pocket costs including plan deductibles, copayments or coinsurance charge.
Flexibility: Are you willing to use only in-network providers?
- Medicare Advantage Plans require you to use their network of providers. Medicare Part A and Part B allow you to access services from any Medicare health care provider.
Medications: How much do you want to pay out of pocket for your medications, and are they covered under your Part D plan?
- There a several levels of coverage for medications. The more you pay in premiums, the more medications are covered and the less you pay out of pocket.
- If you are starting a new medication, find out if the new medication is covered and how much will it cost you out of pocket.
Finally, do not be fooled by advertising!
This is the time of year when we are bombarded with Medicare adds on TV, radio and on-line. When you enroll in a Medicare plan, you are signing up for a standard set of benefits offered by a state licensed insurance company. The federal government sets the standards for coverage, premiums, networks, extra services (e.g. gym memberships), and advertising. Other than cost, the only real difference in plans is the level of service you receive, the plan’s networks, and the type of extra services offered (e.g. gym membership).
I recently saw an advertisement on TV exclaiming the plan’s representatives are “licensed.” As a matter of fact, every person selling Medicare insurance must be licensed! Here is another one: “You don’t pay a premium when you enroll in our plan.” This might lead you to believe that the plan is free, but be sure to look for other costs such as co-payments, coinsurance and deductibles.
Let’s face it. Advertising is meant to reel you in and make you interested in one plan over another. So, before choosing a plan, ask the sales agent “Is this a standard benefit under all Medicare Advantage plans?” or “What are my out-of-pocket costs?“ Or “What happens if I need to go to a doctor who is not in your network?” If the plan’s representative doesn’t give you a clear answer, think twice about signing up with that plan.
For a comprehensive guide to learning about your options and enrolling in a plan for 2021, visit www.weisslawgroup.com for access to the U.S. Medicare plan comparison guide and feel free to contact us at (646) 395-3851 or firstname.lastname@example.org.
Here’s hoping we all stay healthy in 2021!