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Advice For Seniors Selecting Healthcare Plans

Choosing health care coverage can be really confusing. Medicare is a primary resource for seniors, but navigating the ins and outs of enrollment and selecting your best options can become downright overwhelming. We deciphered key points and sorted through jargon to provide you with the highlights you need to know.

First thing’s first

Be aware of your enrollment dates for Medicare. Many people think they will receive a notification when it’s time to sign up, but that’s not how it works. Your initial enrollment period is around your 65th birthday. You get your birth month for enrollment, plus the three months prior and three months following, so 7 months all together. If you miss it, you could face a delay in your coverage and ongoing penalties. You’re actually better off enrolling prior to your birthday to avoid a delay in Part B coverage. To determine your dates, you can use an enrollment date calculator.

Set dates, options, and help

Open enrollment for Part D and Medicare Advantage has set dates each year, and you can enroll between October 15th and December 7th for coverage beginning January 1st of the next year. Sorting through the process is daunting, but thankfully there is an abundance of assistance available, and you don’t need to be a computer whiz to connect.

What are the parts?

As Investopedia explains, Medicare has four parts:

Part A covers hospital stays.

Part Bcovers doctor services, medical equipment, procedures, and the like. Note Part B does not cover things like medications you take home, vaccinations, immunizations, non-prescription medication, dental work, hearing exams, and vision care.

Part C is Medicare Advantage, which is an alternative to standard Medicare. Plans cover everything Medicare covers, as well as things Medicare does not cover, such as dental care, prescriptions, hearing exams, and vision care.

Part D is prescription drug coverage through private insurance companies.

Beyond the basics

You probably have heard of Medigap, but may not be familiar with it and how it differs from Medicare and Medicare Advantage. Medigap insurance comes through private insurance companies. It helps cover things Medicare won’t cover, and you can use it in conjunction with Medicare to help pay for things like deductibles and copays. However, you cannot use the benefits if you have Medicare Advantage as well. CNN points out you can drop Medigap if you have Medicare Advantage.

Other enrollment dates

The many calendar dates surrounding Medicare can be confusing, so here is a basic breakdown. If you missed signing up during the enrollment period around your 65th birthday, the general enrollment period for parts A and B is from January 1st through March 31st. New this year, you can also sign up for Medicare Advantage or add Part D during this period. If you sign up for Medicare between January 1st and March 31st, you can add Medicare Advantage and/or Part D between April 1st and June 30th, which then means coverage for all parts begins on July 1st.

But I’m not retired yet

Many people get confused about Social Security and Medicare. The two used to be joined at the hip in the sense that the threshold ages for both were 65. As U.S. News explains, the Social Security full retirement age is rising, and if you delay until age 70 you can max out your benefits. Enrollment for Medicare remains set at age 65. If you’re approaching age 65, and you or your spouse is getting your insurance through an employer, you have more to consider. Be forewarned, you will need to examine your situation carefully to ensure you avoid penalties and have the coverage you need. AARP offers some guidelines to help navigate your circumstances.

Medicare can be very confusing, and it’s important to know your dates and the ins and outs of what’s covered. Allow yourself some time to think through what you want and need, and connect with assistance when you need to. Ensuring you have health care is a must in order to enjoy good quality of life. 

24th Jan 2024

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