My Medicare Choices

 

Medicare consists of four parts.

• Part A - Hospitalization
• Part B - Physician Services
• Part C - Medicare Advantage
• Part D - Prescription DrugsYou can remain in original Medicare.

There are two ways to get Medicare. You can choose original Medicare, which consists of Part A and Part B and is provided through the Federal government, or a Medicare Advantage Part C plan, which is provided through private insurance companies. Another option, not part of Medicare, is to get supplemental coverage through a private insurance company.

 

Open Enrollment Period

This is also called the Annual Enrollment Period (AEP). During this period members can make changes to their Medicare Advantage and/or Medicare Prescription Part D drug plans. This period runs from October 15th through December 7th each year. Changes made during this period will take effect on January 1st. During this period you can do the following:

 

Medicare Advantage Plans (MA)

• Change from original Medicare to a Medicare Advantage plan.
• Change from a Medicare Advantage plan back to original Medicare.
• Switch from one Medicare Advantage plan to another Medicare Advantage plan.
• Switch from a Medicare Advantage plan that doesn't offer drug coverage to a Medicare Advantage plan that offers drug coverage.
• Switch from a Medicare Advantage plan that offers drug coverage to a Medicare Advantage plan that doesn't offer drug coverage.

Prescription Part D Drug Plans (PDP)

• Switch from a Medicare Advantage plan that doesn't offer drug coverage to a Medicare Advantage plan that offers drug coverage.
• Switch from a Medicare Advantage plan that offers drug coverage to a Medicare Advantage plan that doesn't offer drug coverage.
• Join a Medicare Prescription Drug plan.
• Switch from one Medicare PDP to another Medicare PDP.
• Drop your Medicare prescription drug coverage completely.

Original Medicare

 

What you have paid into during your working career covers Part A. This coverage includes inpatient hospitalization, skilled nursing care, home health care and hospice care. Part B requires a monthly premium to be paid and covers physician services. This includes medically necessary services or supplies and preventive services. Original Medicare has deductibles, copayments and coinsurance. Medicare covers about 80% of medical costs leaving you 20%, which you are responsible for.

 

Medicare Advantage Plans

 

These plans are offered by private insurance companies approved by and contracted with Medicare. Also referred to as Part C or MA plans, these plans combine hospital and outpatient services (Part A and Part B) into one package and can also include prescription drug coverage. With Medicare Advantage the insurance company now pays all claims instead of Medicare. These plans may also have deductibles, copayments and coinsurance costs. You will still need to pay your monthly Part B premium also. These plans also can and do change each year. Not all Medicare Advantage plans work the same way. Different types of plans include:

• HMO (Health Maintenance Organization)
• HMO-POS (Point of Service)
• PPO (Preferred Provider Organization)
• SNP (Special Needs Plans)
• PFFS (Private-Fee-for-Service)

Medicare Prescription Drug Plans

 

You can get optional prescription drug coverage in one of two ways. (1) If you stay in original Medicare or you enroll in a Medicare Supplement plan, you are eligible to enroll in a stand-alone Part D Prescription Drug plan (PDP). (2) If you get your Medicare coverage through a Medicare Advantage plan, these plans ususally have prescription drug coverage (MA-PD) included. There are some Medicare Advantage plans which do not have a prescription drug plan. In those cases you would need to add PDP plan for drug coverage.

 

Medicare Supplement/Medigap Plans

 

Every Medicare Supplement plan must follow Federal and state laws designed to protect you and these plans must be clearly identified as Medicare Supplement Insurance. These plans are sometimes also referred to as Medigap plans. They're offered by private insurance companies which provide additional coverage for benefits and services that original Medicare might not cover. The plan pays the costs; some or all deductibles, copayments and coinsurance not covered by original Medicare. You will pay a monthly premium for your Med Supp plan in addition to your monthly Part B premium. Health insurance companies can sell only "standardized" policies, identified in most states by letters A-N. Any policy is guaranteed renewable even if you have health problems as long as you continue to pay your premiums.

 

Planning for Your Medicare Needs

MSM Capital provides independent advice on Medicare solutions for individuals living in West Central Florida. This includes the counties of Hillsborough, Pinellas, Pasco and Polk. As an independent agent, I can offer clients multiple provider choices for their Medicare needs. Why lock yourself into a relationship with a captive agent who represents only one company. It may or may not be the best plan for you. Many plans change their benefits and network providers each year and 2017 will probably be no different. You have choices and should explore your options before you decide to enroll or change plans.

 

Done your Yearly Medicare Plan Review for 2017?

Annual Notice of Change (ANOC) letters should arrive in your mailbox by September 30, 2016. This letter will inform you of any changes which will occur in your plan for the upcoming plan year. This is a great time to review what and where you've spent your health care dollars during the year and what new medications and/or health procedures you may need in 2017.

 

If you haven't done your Medicare plan review for 2017 yet, give me a call at 813-414-5312 and we can arrange an appointment which is convenient for you to complete one. There is no cost and you could be eligible for a free copy of my book, Navigating the Maze of Medicare - A Comprehensive Look at Your Coverage Choices; 2014 Edition, which is available on Amazon and Barnes&Noble. Elsewhere in Florida, call us toll-free at 888-465-1559. We'll contact you at a time convenient for you so we can review your current plan, answer any questions you might have or if you're new to the Medicare process discuss what options are available to you.