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Medicare Open Enrollment – The Basics

Medicare Open Enrollment 2022

Vascular Vein Centers cares about you and your health. We want what is best for you and your family. We pride ourselves on placing a priority on educating our patients and our community. Many of our patients are insured through Medicare and Medicare Advantage plans.

October 15th through December 7th each year is the annual Medicare Open Enrollment period. Making a mistake in choosing the best plan for you could impact your healthcare and its cost for the rest of your life!

Terry Savage wrote a great column explaining the differences between Traditional Medicare vs Medicare Advantage plans. Terry is a nationally recognized expert on personal finance, the economy, and the markets. She writes weekly personal finance column syndicated in major newspapers and is the author of four best-selling books on personal finance.

Medicare Open Enrollment- The Basics

( Text of article is below)

 

If you need additional assistance, SHINE (Serving Health Insurance Needs of Elders) offers a free program which provides health insurance information and free, unbiased, and confidential counseling assistance to Medicare beneficiaries, their families, and caregivers. Specially trained volunteers can assist you with your Medicare, Medicaid, and health insurance questions by providing one-on-one counseling and information empowering Florida seniors to make informed health care choices.

Request One-On-One assistance: SHINE: Contact Us

 

 

 

Terry's 10/25/2022 Column: 

Medicare Open Enrollment – The Basics

By Terry Savage, October 2022

Here we go again. It’s the annual Medicare Open Enrollment period. Making a mistake could impact your healthcare and its cost for the rest of your life!

You must do more than listen to enticing television commercials, and instead use the Medicare.gov website to search out your alternatives. Here are some of the choices you must consider.

Traditional Medicare vs Medicare Advantage: The annual open enrollment period is the biggest opportunity for for-profit companies to enroll new retirees into these all-in-one plans that promise more coverages and lower prices (or no monthly premiums) than traditional Medicare Parts A, B, and D, plus your supplement.

How do they pay for all those television commercials? They limit your healthcare to physicians, hospitals, and clinics who agree to participate in their networks at lower reimbursement rates.

With traditional Medicare, you can see any physician or specialist who accepts Medicare. But once you’re in an Advantage plan, you are limited to their network, which may not offer the specialists and hospitals you want to use. As well, you may have to wait for a referral to their in-network services. And there will be co-payments for doctor visits and hospital stays. So, it’s not all “free.”

Some slightly more expensive Advantage plans work on a PPO (Preferred Provider) basis. You can use out-of-network providers – at a higher cost. Before choosing an Advantage plan, make sure your physician or hospital is in the network. And be aware that those providers may change from year to year.

That’s the tradeoff of “traditional Medicare” and the offerings of Medicare Advantage plans: Lower premiums vs. limited access. Their networks may change, prescription drugs may be limited to generics, and their hospital contracts may be rearranged in years ahead. And likely, you’ll never recognize the coverage limitations until you need the care.

There is a limit to the out-of-pocket costs you can be charged in an Advantage plan. For 2023, the limit is $8300 for in-network costs such as co-payments. But the plans have a much higher limit (over $12,000) for combined in and out of network out-of-pocket costs.

Clearly, if you are seriously ill, the “advantage” of this low-cost or no-cost monthly Advantage plan disappears quickly. At Medicare.gov you can compare these Advantage programs and coverages and potential costs.

Switching Back from Advantage to Traditional
What happens if you join an Advantage plan, develop a medical condition, and realize you’ve made a mistake? You’re told that if you don’t like your Medicare Advantage program, you can “go back” to traditional Medicare during open enrollment next year.

But if you have developed a medical condition during the year, you will likely not be allowed to go back to your original comprehensive Medicare supplement plan. (You’re only allowed to purchase these top plans without evidence of medical condition if you apply within the first 6 months after becoming eligible for Medicare.) So, when you “return” to traditional Medicare, your new supplement will likely leave large, uncovered expenses for you to pay.

Medicare Supplement Plans When you initially sign up for traditional Medicare, you will pick a supplement that covers things like deductibles, not covered by Part A and B. The time to pick the “best,” most comprehensive plan (F) is at this initial signup.( If you enrolled in Medicare after 2019, you’re limited to Plan G, which does not cover the annual deductible.)

You can expect the monthly supplement premium to increase every year – or if you move to a state with higher medical costs. But typically, you do not want to change your supplement policy to save money, even if monthly premiums rise.

Medicare Part D
You must shop for Medicare Part D every year! These Part D drug plans change not only prices, but covered drugs every year. To find the best Part D plan, go to www.Medicare.gov. Create your own secure account. Input your medications and dosages.
Then their calculator will show you three plans with the lowest out-of-pocket costs. You can apply for a new plan directly from the Medicare.gov website. To avoid penalties, buy Part D even though you don’t currently take prescription drugs. Changing Part D won’t impact any other aspects of your traditional Medicare program.

The Medicare.gov website is your one-stop comparison source for all of these plans. It is amazingly easy to use, and it could keep you from making a long-term mistake. That’s the Savage Truth.

Author
Nadene Weil, Director of Patient & Physician Relations

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