Overwhelmed by Medicare Plans? Our MorningSide Expert Can Help
If you are anything like me, you are tired of seeing JJ and Joe Namath's TV commercials about Medicare. What in the heck do they know about Medicare? Get used to seeing them because we are in the Annual Election Period (AEP), which begins on October 15 and ends on December 7 every year. During this time, anyone who has Original Medicare (Parts A and B) can elect to:
Enroll in a Medicare Advantage plan.
Switch from one Medicare Advantage plan to another.
Leave a Medicare Advantage plan and return to Original Medicare.
Enroll in a Prescription Drug Plan (Part D).
After the AEP, there is an Open Enrollment Period (OEP) for those enrolled in a Medicare Advantage plan. During OEP (January 1 through March 31), a person with a Medicare Advantage plan can change to a different Medicare Advantage plan or return to Original Medicare. Confusing? Please hang in here with me.
When you turn 65, you are eligible for Original Medicare. Medicare Part A pays your hospital bills minus deductibles and copayments, and Part B pays about 80% of your medical bills.
If you have paid into Medicare for ten (10) years, your Part A will be premium free. We all must pay the Part B premium, which is $164.90 for 2023. If you receive Social Security benefits, the government will automatically mail your red, white, and blue Medicare card to you three (3) months before you turn 65. Otherwise, you must apply for Medicare (SSA.gov or 1-800-772-1213).
Original Medicare does not cover prescription drugs. You will have to buy a Prescription Drug Plan (PDP) Part D if you have Original Medicare and want your medications covered. The average cost of a PDP is about $33 per month.
You can also enroll in a Medicare Advantage Plan (Part C), many of which include hospital, medical, and prescription drug coverage. Most healthcare insurance carriers offer a zero premium Medicare Advantage plan with richer benefits than Original Medicare and a PDP. You heard me right—more benefits for less money.
When you first become eligible for Original Medicare, you have a seven (7) month Initial Election Period (IEP), which is three (3) months before your 65th birthday, your birthday month, and three (3) months after your birthday month.
During this period, you can enroll in a Prescription Drug Plan (Part D), enroll in a Medicare Advantage Plan (Part C), or enroll in a Supplemental Plan (Medigap). Medigap plans (which have an alphabet of their own) can provide excellent coverage but can be expensive. Please note that you must have Original Medicare to qualify for a Medicare Advantage or Medigap Plan.
Time and space will not allow me to cover all you need to know about Medicare insurance. So here is a summary of your options:
Original Medicare only (Part A and B) - You pay for your medications, 20% of your medical bills, copayments, and deductibles, and there is no cap on the out-of-pocket cost.
Original Medicare with a PDP: You pay about $33 a month premium for the PDP, 20% of your medical bills, copayments, and deductibles, and there is no cap on the out-of-pocket cost.
Original Medicare with a PDP and Medigap: Depending on the PDP and Medigap plan, you may have little out-of-pocket cost, but you will pay monthly premiums for the PDP and the Medigap.
Medicare Advantage Plan without Prescription Drugs (MA) - You pay for your medications, copayments, and deductibles, and there is a cap on the out-of-pocket cost. You also get additional benefits like dental, vision, hearing, and gym memberships. Most insurance carriers offer zero premium MA plans.
Medicare Advantage Plan with Prescription Drugs (MAPD) - You pay copayments and deductibles, and there is a cap on the out-of-pocket cost. You also get additional benefits like dental, vision, hearing, and gym memberships. Most insurance carriers offer zero premium MAPD plans.
As you can see, there is a lot to understand and very important decisions to make about your Medicare health insurance. Your decision process will also be affected by the number of products the local and national carriers offer. It can be confusing and hard to understand. That’s where I come in.
Medicare Agents/Brokers like me are licensed, certified, and knowledgeable about the Medicare process and can help you navigate this healthcare insurance maze. I would be honored and pleased to offer my assistance in helping you make these critical decisions and answer your questions. My services are free to you. You can contact me via email: sharongray59@gmail.com, or phone at (313) 929- 3980.