We are seeing many ads for Medicare policies on television. Your mailbox may be filling up with solicitations from different insurance companies. This is because Medicare open enrollment starts tomorrow. This happens every year between Oct. 15 and Dec. 7. This is when anyone covered by Medicare is making choices for 2022 coverage.
Let’s discuss a few important facts about Medicare first. Medicare is the national program for all Americans 65 years and older. Everyone must go on to Medicare at that age unless they or their spouse is covered by an employee plan with creditable coverage and 20 or more employees. If you do not start coverage at the right time, you must pay a monthly penalty that will continue for the rest of your life. Original coverage begins when you turn 65 or lose group coverage based on you or your spouse’s work. Medicare is an 80/20 plan with lots of deductibles. Because of this, most people have some kind of supplement to help cover the extra charges.
Now let’s talk about the two types of options you will be considering during open enrollment. One type is an Advantage plan. These plans can range in cost from zero to several hundred dollars per month. Sometimes people wonder how you can get coverage for no cost. These plans receive payment from Medicare to insure your health.
They offer a network of medical providers you may visit. Every network is required to have all medical specialties in their network. While plans differ in benefits, it is not unusual that you can visit your family practitioner at no cost. There may be a small fee to see a specialist and you incur some other out of pocket cost. These plans often offer extra benefits that Medicare does not cover. These might include eye glass coverage, hearing, dental and gym memberships. Most plans include some prescription coverage. Some insurance agencies do not offer these types of policies because they require additional training and testing.
The second type of supplement is a Medigap plan. There are 10 different plan levels. All F plans must cover the exact items. There may be different prices depending on the insurance company. Plan F and G cover the most deductibles and co-pays. With these policies, Medicare from the government is paying most of the cost and these Medigap plans fill in all or some of the gaps.
Medigap plans do not provide any of the extra coverage offered by the Advantage plan and you usually have to buy a separate prescription plan. The costs vary from over one hundred to several hundred dollars. The two main benefits of these types of policies are they have the biggest network of providers. You can see any doctor in the country who accepts Medicare and is accepting new patients. It is also a consideration for people who go to the doctor often. These policies sometimes go up in cost as you get older. To avoid adverse selection, these plans can ask health question and deny coverage. However, the first six months you go on Medicare, you must be accepted by the companies. This is why these companies appeal to people expecting more health issues.
Work with a professional who can explain all of the choices to you, and consider any changes you have had in doctors or medicines. Make an informed choice to help control your health care cost next year.