Are you happy with your relative’s Medicare plan? If not, fall is the annual “Open Enrollment” period. This is when you can change plans for the coming year. Open Enrollment for 2019 is October 15 to December 7.
Even if your loved one likes the current plan, consider any new diagnoses or prescriptions since last year. What was a good deal before may not be the best now.
Here are some tips:
The first decision is whether to go with “original Medicare” or Medicare Advantage. Then look at Part D and Medigap as needed.
- Original Medicare Parts A and B. These government policies pay 80% of the costs for services such as hospitals, lab work, and doctor visits. The premiums are usually deducted from Social Security checks. Patients can choose the providers they wish. Drugs are not covered.
- Medicare Advantage Plans. These plans are typically less expensive and all-inclusive. (You will not need to purchase Medigap and may not need to purchase Part D.) Patients go to a specific set of providers. You’ll want to confirm that the doctors, hospital, and pharmacy you prefer are “in network.”
- Medicare Part D. Think of “D” for drugs. Review your loved one’s medication list. Be sure those drugs are covered in the same dosages. Compare prices at approved pharmacies. One may offer a better deal than the others.
- Supplemental or “MediGap” insurance. These are optional policies. They are purchased to cover the 20% of fees not covered by original Medicare. Prices vary a lot! Lower copays at each visit will result in higher monthly premiums. So will the ability to choose between many providers. Be sure to read the fine print when changing policies. There may be extra fees, a physical examination, or a waiting period for preexisting conditions. Or the insurer may outright turn your loved one down.
Got the insurance blues?
It can be confusing for everyone. Give us a call at 301-593-5285. As the Metro DC experts in family caregiving, we at Debra Levy Eldercare Associates can help you determine the best fit for your relative’s situation.