by Janet Trautwein
(Plain Press, November 2018) Medicare’s Annual Election Period is here. Seniors are choosing their Medicare plans for 2019. They’ll have to make their selections by December 7 for coverage that takes effect January 1.
The enrollment process will be different than previous years. This time, seniors will have the chance to “test-drive” plans at the beginning of the year — and select a different plan if their initial choice doesn’t meet their budgetary or healthcare needs. That flexibility will ensure that Medicare meets the needs of its beneficiaries better than ever before.
Medicare covers about 60 million Americans. Seniors become eligible for all of the program’s components — Parts A, B, C, and D — when they turn 65.
Part A pays for hospital stays. Part B covers doctor visits, same-day surgeries, and potent medications administered in physicians’ offices. Part D is Medicare’s optional prescription drug benefit.
Part C, also known as Medicare Advantage is administered by private insurance carriers and places a cap on the out-of-pocket expenses not available on Parts A and B of Original Medicare. Part C typically includes the prescription drug benefit at no additional cost.
More than 20 million Americans are enrolled in 2,300 different Medicare Advantage plans, each with its own mix of benefits, monthly premiums, copays, and out-of-pocket spending.
Deciding on a plan can be tricky. Beneficiaries must consider lifestyle factors, how much they can afford to spend, and what their future health needs may be.
In recent years, Congress didn’t make those decisions easier. Since 2011, seniors who chose a Medicare Advantage plan had 45 days to “disenroll” if it wasn’t right for them. But their only alternative was enrolling in traditional Medicare.
Thankfully, that won’t be the case anymore. Next year, beneficiaries who enroll in a Medicare Advantage plan will have the ability to switch to another Advantage plan at any point within the first three months of 2019. The change gives seniors much more flexibility and can make open enrollment less stressful.
Seniors may find all these options empowering — and overwhelming. Fortunately, help is available.
Medicare.gov contains a wealth of information that can offer assistance to beneficiaries.
Seniors can consult licensed health insurance agents and brokers. Many have decades of experience and are specially trained to educate consumers. Nearly three-quarters of agents and brokers spend a significant portion of their time explaining coverage to clients and investigating consumer insurance options.
Agents and brokers can help seniors determine which Medicare Advantage plan would be best for them — or whether they’d be better off enrolling in traditional Medicare.
Those who live in a FEMA-declared disaster area during the Annual Election Period may qualify for a Special Election Period outside of the normal enrollment window. Seniors can ask an insurance professional if a Special Election Period has been announced.
Medicare covers nearly one in five Americans. This open enrollment season, that population will find that they have more choices — and more flexibility. Savvy seniors should take advantage.
Editor’s Note: Janet Trautwein is CEO of the National Association of Health Underwriters (www.nahu.org).