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Medicare’s annual open enrollment period begins soon. Meanwhile, Medicare beneficiaries are making important choices that affect their medical bills, the doctors they see, and prescription coverage. There is a lot of information about open registration, but for many seniors the process can be difficult.
Dr. White, Internal Medicine Specialist and Interim Chief Medical Officer at OptumCare Colorado Springs, provides helpful tips and information to help seniors and their caregivers navigate open enrollment. Dr. White has been in the southern Colorado medical community for nearly 25 years as a rural physician in the San Luis Valley, south central Colorado, and Colorado Springs.
Q: How can I get Medicare coverage?
A: There are several ways to get Medicare coverage. You can choose Original Medicare (Parts A and B). Part A is hospital coverage and Part B is medical coverage. Coverage is provided by the federal government.
You can also get benefits through a Medicare Advantage plan (called Part C). Medicare Advantage plans combine Part A and Part B coverage. Many plans also include prescription drug coverage (Part D) and offer additional benefits not provided by Original Medicare. The plans are offered by private Medicare approved insurance companies.
There are also what are known as Medicare supplement plans. These plans help cover some of what Medicare Parts A and B do not pay, such as coinsurance parts, co-payments, and deductibles.
Q: What are some of the things I should think about when choosing coverage?
A: Ask yourself these questions to guide your decisions:
- How often do you see the doctor?
- What prescription drugs do you take regularly?
- Do you have a specific doctor, hospital or pharmacy that you want to use?
- Do you have health coverage for retirement?
- Would you rather pay less monthly premiums or pay less out of pocket when receiving health care?
Q: What’s the best way to get information to make informed decisions during open enrollment?
A: Before considering your enrollment options, make sure the provider network you choose includes the doctors you prefer to see. If you like your doctors, confirm that they will be part of the provider network for the health plan you choose. Don’t assume that your doctors will stay in the same network every year.
You can visit the Center for Medicare & Medicaid Services website at www.medicare.gov; call 1-800-MEDICARE, 24 hours a day, seven days a week; or contact Medicare Advantage health plans directly. You can also find useful information at www.MedicareMadeClear.com.
Another good resource is an independent licensed insurance agent or health plan sales agent. These professionals help Medicare beneficiaries know their benefit options, what will meet their needs, and how they can continue to see the doctors they prefer. They can be especially helpful in explaining health plans that have programs for chronic disease or that cover alternative medicine. Agents usually get a commission for selling you a policy, although they offer plans from a number of health plans.
Question: Why is the topic of health care planning so stressful?
A: Health care is a concern for everyone and people want to make the right decisions that best meet their needs. It can be stressful for caretakers – the people who make these decisions for their friends or family members – because they don’t want to make a decision or recommendation that will financially or otherwise harm the Medicare beneficiary.
At the end of the day, the worst answer is no decision, where people say, “Well, I won’t make a choice, I will leave everything as is because I’m comfortable with it. The more you know, the sooner you know it, you can do your homework, do your research, and then make a decision.
do not wait
Do not wait the last minute. Start early and give yourself time to make the decisions that are right for you.
For more information on how to choose a health plan in Colorado Springs, call 1-866-964-1547.
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