Although we are in the throws of summer, if you are 64 and older it is time to start thinking about Medicare’s open enrollment period, October 15 – December 7th. With the complexities that come with the Medicare programs, it’s better to consider your options sooner rather than later.
Your Medicare Part A coverage becomes effective on the first of the month of your 65th birthday. If you are already covered under group health insurance, Medicare will coordinate with your plan and essentially be invisible to you until you are no longer covered. If you do not have separate insurance, Part A will serve as your hospitalization coverage.
For those people applying for or receiving Social Security benefits, your Medicare Part B will automatically come into effect as well. If you are not collecting Social Security benefits, you will have to apply for Part B coverage yourself, which addresses your outpatient care.
It is important to note that parts A and B provide for your medical care, but come with co-pays, deductibles and unlimited out-of –pocket expenses. At Wharton Insurance, we recommend you either purchase supplemental coverage or join Medicare Advantage (Part C) to help protect you from unexpected medical costs.
Drug Coverage: Medicare does not come with prescription coverage. There are a lot of supplemental drug policy options, so it is important to choose one that serves your particular needs. In these plans, most prescriptions are covered, but the extent of that benefit can vary.
Gaps in Medicare Coverage
|Outpatient Care: The 20% co-insurance within Medicare does not have a cap, opening up the potential for unending medical expenses. Supplemental coverage is available to set limits on your out-of-pocket liabilities.|
|Hospitalization: If you are hospitalized for more that 60 days, your out-of- pocket expenses are unlimited as well. You can purchase a policy to protect you from these potentially exorbitant fees.|
|Drug Coverage: Medicare does not come with prescription coverage. There are a lot of supplemental drug policy options, so it is important to choose one that serves your particular needs. In these plans, most prescriptions are covered, but the extent of that benefit can vary.|
Ahead of the yearly open enrollment period, an Annual Notice of Change will be sent to you regarding your supplemental drug coverage or Medicare Advantage plan. It is important to understand how those changes will affect your medical expenses. Prior to open enrollment is also a good time to review your current policies to make sure the coverage is working as expected. Are you spending more than you think you should – either in monthly premiums or medical bills? Have you started a new prescription that is not covered well under your current plan? Knowing your options will help ensure you have appropriate coverage.
Our Medicare Specialist, Mark Howard, can help you sort through the different Medicare options, finding the best one for you. There really is no right or wrong choice – it is up to you how much coverage you want. Mark helps you balance monthly premiums versus monthly out of pocket risk, applying your current and future medical needs through that lens as well. Send Mark an email, or give him a call at (317) 663-7602 to set up an appointment.