Know your choices to get the most from Medicare
by Angie Hicks, founder of Angie’s List
If you’re at the front end of the baby boomer generation, chances are you’ve been — or are about to be — inundated with Medicare information. Sifting through the mounds of solicitations from private insurers and evaluating the different types of plans is complicated.
Eligible recipients who are still covered by their employer-sponsored benefits can easily ignore Medicare information. Doing so, however, could lead to costly penalties. Boomers need to take control of their health care choices or risk overpaying or facing inadequate coverage in the future.
Independent health care consultant companies — also known as patient advocates — can help you sort through Medicare and private insurance.
Those Medicare choices include:
Part A: Insurance that’s financed by payroll taxes and through monthly premiums deducted from Social Security checks. It helps cover inpatient hospitalization, hospice and medically necessary skilled nursing facilities or home health care (generally, Medicare doesn’t cover long-term care).
Part B: This insurance coverage includes outpatient services, preventative care and doctors’ visits with a premium deducted from a policyholder’s social security check based on his or her income.
Part C, or Medicare Advantage: Private insurance companies approved by Medicare provide this coverage for a monthly premium, which includes a combination of Parts A and B, and in most cases, a Part D prescription drug plan. These plans may offer coverage such as vision, hearing and dental.
Part D: Covers prescription drug costs. Purchased through private insurers, it’s available to those enrolled in Parts A and B and to most with Medicare Advantage.
Medigap: Supplemental coverage through private insurers that helps offset out-of-pocket costs not covered under Parts A and B. If you have a Medicare Advantage plan, you can’t purchase Medigap.
Most people who are turning 65 need to sign up for Parts A and B, including those who are still working and aren’t getting social security. Those who have health insurance through their employer can decline Part B coverage; however, they must defer that option during their seven-month initial enrollment period — which includes the month you turn 65 and the three months before and after — to prevent getting a penalty or denied coverage in the future.
According to an online poll of Angie’s List members, nearly one in four seniors say they aren’t aware of such penalties. Delaying enrollment without a deferment could increase your premium by 10 percent each year.
When shopping around for private coverage, it’s equally important to determine the differences in the policies, or you could overpay and be underinsured. Angie’s List offers reviews on insurers. Our online Healthcare Blue Book tool can also help you identify how much you should pay for various local medical services.
Once enrolled in Medicare, you won’t need to re-enroll, but you can elect to change your coverage each year during the open enrollment period from Oct. 15 to Dec. 7.
“Keep in mind that the coverage you need this year might not be the coverage you need next year,” says Adrienne Muralidharan, senior Medicare specialist for highly rated Allsup, a financial and health-care related services company based in Belleville, Ill. “People get comfortable in their plan, [but] maybe they could save a few hundred dollars with a different one.