If youâ€™re one of 56 million Americans eligible for Medicare, itâ€™s important to understand coverage options when selecting your health plan for 2020. Research can take time, and many people find working with a licensed health insurance agent helpful when deciding between Original Medicare, Medicare Advantage plans, prescription drug plans, and Medicare supplement plans. Answering these five questions can help you make an informed choice during the Medicare annual election period Oct. 15 to Dec. 7:
Are my doctors, hospitals and specialists in-network?
Most Medicare Advantage plans offer online tools to help you find doctors and hospitals that are in a planâ€™s network. A licensed agent can also help you look up hospitals and doctors to see if theyâ€™re in a planâ€™s network and taking new patients, and confirm whatâ€™s in-network if youâ€™re a seasonal resident.
Which plans will cover my prescription drugs?
Original Medicare does not cover most prescription drugs. Many Medicare Advantage plans include prescription drug coverage, or you can sign up for a Part D prescription drug plan separately. A licensed agent can look up the medications you would like covered and help you estimate what the cost of each drug would be on a plan.
Are there new, innovative benefits I should consider?
Beyond vision, hearing and dental coverage, if you aim to become healthier, look for fitness program benefits, as many Medicare Advantage plans offer a gym membership. If you travel or appreciate technology, virtual doctors are helpful services when you canâ€™t see a doctor right away. Most Medicare Advantage plans now offer transportation to doctor appointments and the gym.
Will a zero monthly premium plan save me money?
Private insurers help keep premiums down through programs like disease and chronic-care management, which help people better manage health conditions and, in turn, reduce medical costs. Youâ€™ll still need to pay your Medicare Part B premium, which covers medical services and preventive care. You might want to use the additional premium dollars you save for out-of-pocket medical costs, such as co-pays.
Do I need to sign up for Medicare Parts A and B if Iâ€™m still working?
If you or your spouse have health insurance from an employer, you can delay enrolling in Medicare until the employment or the coverage stops. At that point, youâ€™re entitled to a special enrollment period of up to eight months to sign up for Medicare without incurring any late penalties.
Resources are available to help you in this process, including licensed sales agents, local seminars, and websites such as medicare.gov. You can also call 1-800-MEDICARE (1-800-633-4227) (or TTY: 1-877-486-2048) 24 hours a day, seven days a week.
As with any major decision, proper research will go a long way toward making the best plan choice for your personal healthcare needs.
Catherine Field, who wrote this article, is a market president of Humana, a Medicare organization and standalone prescription drug plan with a Medicare contract.
A GOOD TIME TO EVALUATE PROVIDERS
Starting Oct. 15, Medicare entered its annual enrollment period (AEP). Do you know how to select a Medicare plan and primary care provider? For instance, did you know that having a Medicare Advantage plan could cut ER visits by 33 percent? Now is the time to evaluate whether your insurance plan and primary care provider are right for you.
Medicare Part A and Medicare Part B together are known as Original Medicare. Medicare Part C is most often called Medicare Advantage. These three parts make up the core components of Medicare coverage, but are different from Medigap plans. Navigating the alphabet soup of Medicare can be tough, and plans, benefits and your healthcare needs can change each year, so take some time to evaluate your current plan to see if it still works for you.
Selecting the right primary care provider is also one of the most important decisions you can make during AEP. Does your current doctor know you, your family, your hopes and fears and your health goals? AEP is a good time to evaluate if your current provider is working for you. Here are some signs it might be time to make a change and switch providers:
- You feel rushed during appointments. You should have enough time to have your concerns addressed and your questions answered.
- You donâ€™t know your primary care provider. Itâ€™s important to know and trust your provider so you can be honest about your health. Itâ€™s also important for your provider to know you.
Source: Iora Primary Care, which has practices in Seattle, Tacoma, Puyallup, Federal Way, Renton and Shoreline.