Medicare enrollment can be a complex and mystifying process for seniors. It is safe to say Medicare even has its own lexicon as the Centers for Medicare and Medicaid Services online glossary included over 4,500 Medicare terms and acronyms! However, the reason many people find Medicare confusing goes far beyond the acronyms, terms and jargon. The core issue is the general lack of health insurance literacy among beneficiaries. To help curb this issue, Pat Salas, President of SBHIS Insurance Services, has compiled a breakdown of coverage options.
The first action seniors can take is to make no changes to their existing plan. However, this can be financially risky and even lead to bankruptcy in some cases.
The second is a stand-alone prescription drug plan. This covers medication costs and prevents the member from having penalties added to their Medicare premium.
For the Medicare Supplement plan, the person has the freedom to go to any contracted medical provider in the country without a referral. They are responsible for paying a monthly premium and are required to purchase a stand-alone prescription drug plan to cover their medication costs.
The Medicare Advantage plan is the most popular plan. This involves choosing a primary care physician, who can then refer the beneficiary to specialists within the network they belong to. While they are no longer responsible for the original Medicare 20% coinsurance, they are expected to pay preset copays.
Keep in mind that the annual enrollment period runs from October 15 to December 7 every year. This is the best time to review coverage options and make adjustments if necessary. The open enrollment period, which runs from Jan 1 to March 30, allows people to switch or join a Medicare Advantage or stand-alone prescription drug plan. Since Medicare plans change each year, it is a good idea to make sure your coverage still meets your needs. SBHIS is always happy and able to assist.
