Medicare open enrollment is right around the corner. If you are already using a Medigap plan or a Medicare Advantage plan, now is your time to move if you want to change your carrier.
When is the open enrollment period?
October 15th through December 7th of every year.
Who needs to pay attention?
Those using a Medigap plan, Medicare Advantage plan, prescription drug plan, or if during your initial enrollment period you opted not to purchase additional coverage above traditional Medicare parts A & B.
What is traditional Medicare?
Traditional Medicare is composed of three parts: A, B, and D. Part A is coverage for hospitals and doesn’t have monthly premiums. Part B is coverage for doctor visits, etc. and the base cost is $134 per month for most people. This typically comes out of your monthly Social Security check. Part D is prescription drug coverage purchased from a third party.
What is the difference between a Medigap and Medicare Advantage plan? Medigap is an additional insurance that complements traditional Medicare. It covers most of the “gaps” or holes that are not covered by parts A & B. You can go to any doctor that accepts Medicare.
Medicare Advantage plans combine parts, A, B, D, and Medigap into one nice package. They operate more like traditional insurance where they have a service provider and you are tied to their network.
What else should I know about Medigap? Medigap plans are lettered from A to N with costs that vary depending on the benefits provided. The most popular plan is F as it is the most comprehensive and covers things like the Part B deductible and foreign travel emergencies. Because it is the most comprehensive, it is usually the most costly. However, by rule, any Medigap plan has the same benefits regardless of the service provider, even though the costs can vary significantly.
The only differentiator between companies is the level of service. Price then is a driving factor, but you should use a provider that is reputable. People that have comprehensive Medigap plans may pay more on a monthly basis, but typically don’t have to pay very much out of pocket. If your health is ok to poor and you see a doctor regularly, then this may be a good option for you.
What else should I know about Medicare Advantage plans? Medicare Advantage plans, also called Part C, will often cost less than Medigap plans. They will typically have deductibles and co-insurance like traditional insurance through an employer. They work by Medicare giving an insurance provider a certain amount per year to manage your expenses. If the insurance provider manages your expenses for less, then they make money. Because of that, monthly costs vary significantly with some plans as low as $0 per month.
People that use Medicare Advantage plans usually pay less on a monthly basis, but typically have more out of pocket expenses. If you are in good health and don’t regularly see a doctor, then this may be a good option for you.
What are some small facts that have big impacts? When you originally sign up for Medicare, you can choose either Medigap or Medicare Advantage without being denied. If you are on a Medicare Advantage plan and then try to go back to a Medigap plan, you could be denied based on health. You will never be denied access to a Medicare Advantage plan.
Are there any differences between prescription drug providers? Yes, costs can vary significantly. Shop around to find the best deal for your specific medication regimen. You can also go to Medicare.gov, enter the prescriptions you take, and it will screen for the best providers. To get there, visit Medicare.gov and click on Drug Coverage (Part D), then click on Find Health & Drug Plans.
What resources are out there to help me research my options? The website www.medicare.gov has a plethora of information. You can use it to sign up for Medicare or any of its parts A, B, C, or D. You can also find contact information for Medigap providers. If you would like to speak to a person you can call 1-800-Medicare (1-800-633-4227).
