Where To Get Help With Medicare Open Enrollment

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By Penny Ross, MPH Resource Coordinator, and Robin Michel

It’s no secret that Medicare can be complicated, with Part A, Part B, Part D, Medicare Supplement and Medicare Advantage.

What does it all mean?

As a Medicare beneficiary, you have from Oct. 15 to Dec. 7 to review your coverage and make any changes for 2018.  Changes made take effect Jan. 1, 2018.

Here’s a quick-hit guide to Medicare:

Q: What is Medicare?
A: Medicare is a federal health insurance program for people aged 65 or older or for those under age 65 who have been receiving Social Security Disability payments for 24 months.

Q: What are the different types of Medicare coverage?
A: Medicare Part A is hospital insurance.  It covers inpatient hospital stays, care in a skilled nursing facility, hospice care and sometimes home health care.  Typically, Medicare Part A is premium free.  Under Medicare Part A, you may be responsible for a deductible, copays or coinsurance.

Medicare Part B is medical insurance.  It covers your doctor visits, outpatient services- such as lab work, x-rays, medical supplies, and preventive services.  There is a monthly premium for Medicare Part B.  There is also an annual deductible, after which Medicare generally pays 80% and you pay 20% for the Medicare approved charges.

Medicare Part C is also known as Medicare Advantage Plans.  Medicare Advantage Plans are offered by private insurance companies approved by Medicare.  They cover everything that original Medicare (Part A and Part B) covers, but may include additional benefits such as fitness, dental, hearing exams, etc.  You must be entitle to Medicare Part A and enrolled in Medicare Part B to be eligible to enroll in an Advantage Plan.

Medicare Part D is prescription drug coverage.  In 2006, Medicare required all Medicare Beneficiaries to have creditable prescription coverage.  If you don’t join a Medicare Prescription Drug Plan when you’re first eligible you may be subject to a penalty.  If you have a prescription drug plan through a retiree pan, the VA, or some other plan that is as good as or better than Medicare you are not required to purchase a Part D plan.

Medicare Supplement plans are designed to “fill in the gaps” to Original Medicare.  Medicare Supplement plans work with Original Medicare, not Advantage Plans.  The may help pay for your deductibles, coinsurance or copays, and may offer additional benefits.  Medicare Supplement plans don’t include prescription drug coverage and are sold by private insurance companies.

Enrolling in Medicare can be intimidating but it’s important to understand the different parts of Medicare and have the proper coverage.  There are only certain times you can enroll and make changes to your coverage. If you need more help understanding coverage or how to enroll in an appropriate plan the Center for Healthy Aging can help you.

The Center for Healthy Aging has CHOICES counselors at The Hospital of Central Connecticut’s New Britain and Bradley campuses; Windham Hospital; MidState Medical Center; Hartford Hospital; and family health centers in Vernon and Bloomfield. Call our toll-free number (1.877.424.4641) to ask for help from a CHOICES counselor.

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