By Barry Streit, CLU
Medicare’s annual enrollment period is upon us — the time (October 15 to December 7) when people can make changes to their Medicare coverage for the year ahead.
Thankfully, there are tips and resources to help you navigate the process and select a plan to meet your needs. Here’s a roundup of frequently asked questions about Medicare, and considerations that can help you get started in your own decision-making process.
How do I know which type of Medicare coverage is right for me?
Each person should make coverage decisions based on their health care needs and budget. To do that, you need to understand your options.
Original Medicare (Parts A and B) is provided by the federal government and includes hospital and medical coverage. But it doesn’t cover everything. You may have out-of-pocket costs like deductibles, copays, and coinsurance. Coinsurance for most Part B services, for example, is 20 percent of the cost. In addition, original Medicare does not cover prescription drugs. If you want additional coverage, there are two main ways to get it:
- Add Medicare supplement insurance and/or a standalone Medicare prescription drug plan (Part D) to Original Medicare.
- Choose a Medicare Advantage plan (Part C), which combines Part A (hospital insurance) and Part B (medical insurance) in one plan. Most plans include prescription drug coverage (Part D), and many offer coverage for things like routine dental and eye care. Medicare Advantage plans also put a cap on your out-of-pocket costs for the year. There’s no cap with original Medicare.
Does Original Medicare cover dental, vision and hearing care?
Original Medicare (Parts A & B) does not cover routine dental, vision, or hearing care. Some costs may be covered if you have an eye injury or a certain medical condition, such as diabetes or cataracts.
Many Medicare Advantage plans cover dental and vision care, including routine eye exams, eyeglasses or contacts.
Medicare Part B covers diagnostic hearing and balance exams if your doctor thinks you may need medical treatment, but neither Part B nor Part A covers routine hearing tests or hearing aids. Many Medicare Advantage plans offer this coverage.
How can I get coverage for my medications, since original Medicare doesn’t provide it?
You have two options for prescription drug coverage: You can add a standalone Part D plan to original Medicare, or you can join a Medicare Advantage plan that includes prescription drug coverage.
Look for plans that cover the drugs you take. Each plan has a formulary that lists which drugs are covered and what the cost is. Most formularies are tiered, dividing drugs into different levels of cost. Typically, low-tier drugs will cost less than high-tier drugs.
Why are the costs for my prescription drugs changing? Can I switch plans?
Part D prescription drug plans may change copays, premiums, deductibles and other costs from year to year. They may also add or delete specific drugs from their formularies.
If your drug costs change, you are free to shop for a different plan during the Medicare annual enrollment period. You can look for plans using the Plan Finder at Medicare.gov.
The bottom line
You have choices to make when it comes to Medicare. But you’re not alone in this process. There are online resources to help you navigate the process and select a plan to fit your needs.
Looking to learn more? Visit GetToKnowMedicare.com to access resources to help you prepare and make confident Medicare decisions.
About the author: Barry Streit, CLU®, ChFC®
Barry is senior vice president at UnitedHealthcare Medicare Solutions, and oversees direct-to-consumer sales, field agent support, and business development. Prior to joining UnitedHealthcare, Barry held various financial services leadership roles at Charles Schwab & Co., BMO Harris, and TD Ameritrade. He holds the CLU® and ChFC® designations, has a Bachelor of Science from the University of Florida, and an MBA from the University of Notre Dame.
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