Only a few weeks remain in the open enrollment period for Medicare, which ends Dec. 7. If one is interested in changing plans, effective Jan. 1, one needs to do so by that deadline. If one takes no action, they will remain in the current plan.
One of the most important factors for many families is the cost of prescription drugs. If medicine is very expensive, one might consider switching to a Medicare Advantage plan if you find one that saves you money, or you might consider switching to a different Part-D prescription plan.
According to the Centers for Medicare and Medicare Services, some Medicare Advantage plans are offering reduced drug costs for diabetes patients. For example, many plans offer a 30-day supply of insulin for a co-pay of approximately $35 per month. For some diabetes patients, this may save these patients over $400 per year.
However, there are other factors you have to take into consideration. Medicare Advantage plans have pros and cons.
The advantages include: The monthly costs are lower. You no longer need to purchase Medigap policy to compensate for the 20% of Part B not covered. You may not need to purchase a Part D prescription plan. Many Advantage plans include other features such as dental, vision, hearing aid coverage, fitness programs and transportation services. Traditional Medicare does not cover these features. Premiums, in general, have been decreased for many Advantage plans.
Disadvantages include: You may have more co-pays associated with a Medicare Advantage plan. A significant disadvantage is that you will be restricted to in-network health providers. If you are comfortable with your current doctors, make sure you may continue to use their services. If you need a health specialist, you will need to obtain approval from the plan. Such approvals are not required with traditional Medicare coverage.
If you currently have Medigap coverage and switch to a Medicare Advantage plan, in most cases you will not be able to obtain Medigap coverage from the same insurance company if you decide to switch back to traditional Medicare coverage. However, you may be able to obtain Medigap coverage from a different insurance company.
At Medicare.gov, one can obtain cost estimates of various options associated with both original Medicare and Medicare Advantage options. One can compare the costs of various Part D drug plans, Medigap plans and Medicare Advantage plans. You can specify the drugs you use in order to determine which plans offer the best options. Enter your zip code, and you will find the plans available in your area.
Another excellent resource for Medicare information is “Medicare & You 2021,” the official U.S. government Medicare handbook available from the U.S. Department of Health and Human Services. This book will include cost information for the plans available in your geographic area. You can request the handbook by calling Medicare at 1-800-633-4227, or order from: firstname.lastname@example.org. Enter your zip code when requesting.
An excellent free source of information for health insurance counseling in general, or Medicare in particular, is ving Health Insurance Needs of Elders). You can find a contact for your state on the internet. I volunteered with SHINE for several years. They provide excellent services.
Finally, I highly recommend the book “Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs” by Philip Moeller (Simon & Schuster). It covers all aspects of Medicare. If one is eligible for Medicare for the first time, this book will be very valuable. It is important that one consider all of their options carefully before enrolling in Medicare the first time.
(Elliot Raphaelson welcomes your questions and comments at email@example.com.)
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