Every year – usually in the fall it is time for all of us to do our annual check to see if our insurance will be meeting our needs for the next year. We all need to look at our Medicare, what we have for a supplemental and what our prescription policy covers.
So, for Medicare – do you have Part A and Part B? A covers the hospital and B covers about 80% of all of the other approved services. Part A is covered when you apply for Social Security and if you select to have Part B it is taken monthly out of your Social Security.
To cover the other 20% of Part B, you can choose a supplemental insurance and there are a lot of plans to pick from. Or you can choose to self-pay that 20%.
If you choose to have a supplemental plan, then you should review that the plan you have is the best one for you for the next year. Then pick the company that offers your plan at the lowest monthly rate. All plans at each level offer exactly the same coverage. They just charge different fees.
For example, Plan G might be offered by 14 insurance companies. The prices can range from say $200.00 a month up to say $500.00 a month. The coverage is identical in all of the Plan Gs, so buy the $200.00 a month plan and you will save a lot of money.
It’s very similar when you check for your prescription plan which is Part D. Buy the best deal for you. Deciding is a little more complicated as you want to check that the medicine you are taking is covered by the plan you buy. Visit Medicare.gov and select “find health and drug plans” and plan on spending a half hour or more checking what you have, and which plan will be best for you next year. Be sure you are comparing drug coverage, deductibles and copays.
Then there are Medicare Advantage Plans. These are very similar to an HMO or a PPO where you pick providers from the in-network list. Generally, there is no monthly premium for health coverage. You might need to change doctors but maybe not. And these savings sound very attractive but be sure you are prepared as you will have copays for visits to the doctor, fees if you go to PT and for other services. These out of pocket costs can be as high as say $5,000 up to $6,700 for in-network before your plan kicks in again. And remember this is per person.
So if you are picking a Medicare Advantage Plan you might want to set up a separate bank account with $5,000+ in it so if you or your spouse falls ill you have the money to pay those out of pocket costs. No one needs to be worrying about money when dealing with an illness or accident.
With all of this said, set aside at least an afternoon to review your coverage, your insurance plans, changes in your health and your prescriptions for the last year, then look into what coverage you want for next year.
If this is overwhelming, reach out and ask an expert for help. Visit SeniorCenterCt.org and call your Senior Center or Senior Resources. All of the phone numbers are there for you. And the sooner you do this the better. Open enrollment starts Oct 15 and ends December 7th. If you do nothing your coverage will stay the same as what you have now. So, start today looking at your coverage and deciding if you need help. Those professionals are waiting for you to call and best yet their help is FREE!
