Navigating Medicare Options and Enrollment to Find Your Fit
you’re a senior who has been on Medicare for a while, or you’re just approaching retirement and wondering where
to start, trying to understand the ins and outs of your coverage can feel like a big undertaking. With so much at stake, you
want to be sure you’re making the right decisions for yourself or a loved one. There’s no mistaking that Medicare
is complex, but these are the key takeaways every senior needs to know: the options you can choose from, when and how to enroll, and where you can turn for
Know Your Options
If you’re new to the world of Medicare, the first thing to know is that “Medicare”
isn’t just one plan that everyone has. Under this umbrella term, you actually have two primary options:
Parts A and B - Also known as Original Medicare, this is what
many people are enrolled in automatically at age 65. Part A provides insurance inpatient hospital care, while Part
B provides insurance for regular doctor visits and other outpatient care. Part B also includes coverage for some other medical needs, such as lab tests, X-rays, medical equipment,
and mental health services.
Medicare Part C (Medicare Advantage) - As an alternative to Original Medicare, you can choose a Medicare Advantage plan, which takes
the place of Parts A and B. Medicare Advantage plans are sold by private companies, and in addition to coverage for doctor visits and hospital care, many also
provide coverage for medical needs that aren’t covered by Original Medicare.
Medicare Part D is an optional add-on plan that provides coverage
for prescription drugs. Some Medicare Advantage plans include prescription drug coverage, so you may
or may not need Part D if you have enrolled in Medicare Advantage.
One of the most important things for seniors to know is that Original Medicare isn’t free. For this reason, it’s a smart idea to research Medicare
Supplement options that help fill in these gaps. You can find plans through private insurance companies like Mutual of Omaha
that help cover those out-of-pocket expenses you run into with Original Medicare. Common out-of-pocket costs include coinsurance,
copayments, and deductibles. Having them covered by a supplement gives you peace of mind because it takes away the fear of
being hit with surprise medical bills.
When and How to Enroll
One of the best
resources for making sense of the steps involved is the Getting Started guide on Medicare.gov. This resource provides a timeline
for finding and choosing plans when you become eligible at age 65. Be sure to note that if you aren’t enrolled automatically
and don’t enroll on time, you may have to pay a late-enrollment penalty. When you’re ready to enroll, first check
into whether you are enrolled automatically. If you aren’t, you can enroll in Original Medicare online through the Social Security Administration, or find a Medicare Advantage plan through the Medicare Plan Finder tool.
When you’re already enrolled in Medicare, you can review your plan and make changes during
open enrollment, which is from October 15 through December 7 every year. Everyone is eligible
for open enrollment, whether you have Original Medicare or a Medicare Advantage plan. Because plan details and costs are constantly
changing, the website Retired Brains recommends looking at your plan every year to determine if it’s still the best fit for you.
Keep in Mind
One of the most important things to do throughout this
process is to look at total costs. Researching and enrolling in Medicare can be overwhelming, but you don’t want to
select the cheapest option you come across. Remember that what seems cheapest at face value may have out-of-pocket costs you
choices is good in many ways because it means all seniors aren’t put in the same one-size-fits-all box. Finding the
right choice boils down to your particular situation because your budget, income, and health needs are all part of the picture.
Ultimately, looking at the bigger picture is crucial to navigating this process and finding the right fit for you.
With thanks to James Hall from Seniorcarefitness.com.