What to know about Medicare enrollment

SeniorWomanNurseHC1409_X_300_C_YFor many seniors, enrolling for Medicare coverage can be a nightmare of red tape and complicated bureaucracy. The ever-changing rules and annual requirement to sign up can throw you for a loop if you’re not vigilant.

Medicare’s open enrollment period starts October 15 and runs through December 7. During that time, applicants can sign up for Medicare coverage, change the details of their plan or decide to keep everything the same as last year. But regardless of whether you want anything to change, open enrollment provides a great opportunity to learn about potentially beneficial program changes.

Marsha Neal, vice president with insurance provider Vibrant USA, said the most common mistake people make is taking for granted that their coverage will also remain the same.

“Folks need to get accurate information and enough information,” she said. “A person needs to check to see if all their providers accept the health plan they choose. They should also carefully check the coverage for their prescriptions and make sure they understand all the costs and risks under their plans before enrolling.”

It’s important to keep in mind that Medicare, Medicare Advantage and Medicare Part D are all different programs that require various levels of input from the user.

Original Medicare is the program most are used to, the one that’s been in place since 1965. This plan is separated into Part A and Part B. Part A covers hospital insurance, inpatient operations or home health services. Part B is everyday medical insurance, and covers necessary treatments that accompany average visits to the doctor: X-rays, diagnostic tests, nursing fees and some vaccinations.

Medicare Advantage was started in 1997, and is often referred to as Part C. The significant difference between the two programs is that Medicare Advantage allows the user to receive Medicare benefits from their own private health plan, with the insurance carrier receiving payments from the Medicare program to help subsidize the cost.

The biggest difference between Medicare and Medicare Advantage is how much you pay. Original Medicare typically has a monthly premium between $100 and $335, depending on yearly income, and $150 deductible for Part B benefits. Medicare Advantage premiums will usually be lower, depending on the insurance provider, but require a copay at the doctor’s office.

Part D covers prescription drugs, and can be paired with both regular Medicare and Medicare Advantage. Original and Advantage plans will have different rules and fees concerning how prescriptions are handled, so check with your provider to see if you qualify.

It may all seem confusing, but it’s important for seniors to sign up quickly to get their benefits. Senior citizens become eligible for Medicare coverage when they turn 65, and must be signed up during the initial enrollment period three months before their 65th birthday. Failing to sign up on time could add a penalty to Part C and D programs. Missing a deadline by even a month reads as missing the deadline by a year, and for every “year” late, you get an additional 10 percent penalty on Part B coverage.

For more information on Medicare, consult the Medicare website at medicare.gov, or contact one of several local insurance providers.

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