Many older adults do their best to financially plan for their retirement. However, senior care is enough to break any budget, especially when unexpected illnesses are involved. That’s why many adults choose to take advantage of Medicare coverage, a national, government-funded health insurance that’s available to adults aged 65 and older.
Medicare coverage allows adults to reduce their risk of high out-of-pocket costs by taking advantage of free preventative services while shopping around for what best suits their needs. With open-enrollment right around the corner (October 15th through December 7th), it’s important to do your research before choosing a Medicare enrollment plan.
What Do I Need to Know about Medicare Coverage?
Depending on the plan and the parts of Medicare you are signing up for, the enrollment periods can be different. The Centers for Medicare and Medicaid Services have a wide variety of resources available on their website. Here’s what they say about the different Medicare enrollment periods.
Initial Medicare Enrollment
This period is for enrollment of parts A and B (see below). Adults are eligible to enroll three months before the month of their 65th birthday and three months after. However, those who are already taking their Social Security benefits are automatically enrolled in parts A and B.
General Medicare Enrollment
Don’t worry if you miss out on initial enrollment. General enrollment for parts A and B allow adults to enroll from January 1 to March 31 each year. However, just be aware that the longer you wait, the more you have to pay in premiums. It’s possible that your premiums can increase by 10% or more the longer you wait to enroll.
Annual Medicare Open Enrollment
If you are joining plans or changing parts C and D, you can do so between October 15 and December 7 of each year. This is great for adults whose healthcare needs have changed.
Four Main Parts of Medicare Coverage
There are four main parts that make up a Medicare coverage plan. Within each part there are different options that meet various needs. Adults who are eligible for Medicare are allowed to choose any combination of these plans depending on the coverage they need.
• Part A covers inpatient hospital stays, care in a skilled nursing facility, and home health care. If you’ve paid Medicare payroll taxes for at least 10 years, the cost for this coverage is free, plus deductible.
• Part B includes doctor visits, outpatient care, medical supplies, and preventative care. A monthly premium is calculated depending on your yearly earnings, plus a deductible, copay, and coinsurance.
• Part D adds prescription drug coverage to your plan of choice. The cost for Part D includes your monthly premium, deductible, copay, and coinsurance.
• Part C is called Medicare Advantage, which is offered through private insurance companies. You might think of this as an all in one plan that usually bundles parts A, B, and D.
Tips for Enrolling in Medicare
Whether you’re enrolling for the first time or have been covered by Medicare for years, it’s a good idea to reevaluate your plan each autumn season before open enrollment. As you consider your needs for the upcoming year, keep these tips in mind.
Part D, which covers prescription drugs, can change from year to year. This means that medications that were covered previously, might not be covered by your plan the next year. You might consider checking to see if all of your medications will be covered in the coming year. If they aren’t, you can make changes on the Medicare website.
Request Pharmacy Pricing
In our current economic and political climate, pharmacies and the cost of medications can be unpredictable. In order to get the best prices for your medications, you have to do your research. The Medicare website allows you to search your specific prescriptions and pharmacy options.
Purchase a Supplemental Policy
Not all of your medical needs will be covered by Medicare. Many older adults choose to purchase a Medigap supplemental plan to cover the difference. These supplemental plans can cover anything from hearing aids and vision care to international coverage.
Medicare Coverage Advantage Plan
Advantage plans are offered by private insurance companies and offer comprehensive health coverage. These plans are especially helpful as you age and your healthcare needs begin to increase. They offer greater benefits such as hospital care, dental, hearing, and drug coverage.
Things to Consider About Medicare Coverage
Choosing your Medicare coverage can be a lot to dissect. However, doing your research and thinking about your needs will help you in the long run. Consider using the items below to inform your decision-making process.
• Cost- The cost of healthcare coverage can add up quickly. While you’re evaluating your coverage, pay close attention to the cost of each element such as your hospital stays, yearly limits, premiums, and deductibles.
• Coverage– Make sure your plan will cover the services you know you will need like medical services and supplies.
• Prescription Drugs– If you take medications, you should consider Medicare Part D closely. It can be helpful to ask questions such like, is there a penalty if you join a drug plan after enrollment? What’s your plan’s rating? What are the cost of your prescriptions?
• Doctor and Hospitals– If you feel strongly about keeping the same doctors or visiting the same facilities, make sure they are covered by your potential plans. Many plans have restrictions and preferred care providers.
• Quality of Care– If you weren’t satisfied with the quality of your care in previous years, you should consider changing plans. If you’re new to Medicare, you can search plan ratings from people with the same coverage.
• Travel– If you frequently travel out of the country and need healthcare coverage, a Medicare Advantage might be a good fit. The Original Medicare plans do not cover international travel.
Navigating Your Journey at Maplewood Senior Living
Healthcare coverage is an expensive part of aging. However, Medicare coverage was designed to carry some of the burden so older adults have access to the care and services they need. At Maplewood Senior Living, we know aging can be a challenging journey. We are here for our residents and their families as they face these complex transitions and navigate the costs associated with senior living. To learn more about our communities, don’t hesitate to contact us.