Top 10 Questions About Medicare Open Enrollment
Understanding how Medicare works and making decisions about your 2017 Medicare coverage options can be confusing and overwhelming. That's why we've put together the top 10 questions we receive during Medicare open enrollment.
What is open enrollment and what can I do?
Open enrollment is the time of year when you can review your current Medicare coverage and make any changes for the following year. Medicare open enrollment begins Oct. 15 and ends Dec. 7 each year. During this time, you can join, switch or drop your Medicare Advantage or Prescription Drug Plan. Your coverage will begin on Jan. 1 of the following year. Watch our Medicare Open Enrollment Video to learn more.
If I am happy with my current Medicare coverage do I need to do anything?
If you are happy with your current coverage, you do not need to do anything during open enrollment. You will remain in the same plan the following year.
If, however, your plan is nonrenewing or reducing its service area, you will need to make a decision regarding your coverage for the following year. Your plan will call or send you a letter explaining your options for Medicare coverage.
What is the cost of Medicare Part A and Medicare Part B?
You usually do not pay a monthly premium for Medicare Part A (inpatient/hospital insurance) coverage if you or your spouse paid Medicare taxes while working. You pay a monthly premium for Medicare Part B (outpatient/medical insurance), which is based on your IRS tax return from two years prior. The standard Part B premium amount in 2017 will be $134. Depending on your income, you may pay more. In addition to your monthly premium(s), Parts A and B of Medicare also have deductibles and co-insurances you are responsible for paying.
Do Medicare Parts A and B include drug coverage?
If you would like to have drug coverage, you may choose a Part D plan, which covers only drugs, or a Medicare Advantage plan (Part C) that includes drug coverage.
Medicare Part A does not include drug coverage. Medicare Part B generally doesn't cover most prescription drugs used at home, but it does cover a limited number of outpatient prescription drugs under limited conditions. Generally, drugs covered under Part B are drugs you wouldn't usually give to yourself, like those you get at a doctor's office or hospital outpatient setting.
What is a Medicare Advantage (Part C) plan?
Medicare Advantage (or Part C) plans are offered through private insurance companies and provide you with your Medicare Part A and Part B benefits and may also include additional benefits like drug, vision, hearing and dental coverage. These plans may offer low or $0 monthly health plan premiums beyond what you pay for Medicare Part B outpatient coverage. Watch our Medicare Advantage Part C Video to learn more.
What is a Medicare Supplement (Medigap) plan?
Medicare Supplement or Medigap insurance is a plan offered through private insurance companies that can help pay for some of the costs that Medicare Parts A and B require you to pay. This would include copayments, coinsurance and deductibles. Medicare supplement plans supplement your Original Medicare benefits. When you have a Medicare Supplement plan you can continue to go to any doctor or hospital that accepts Medicare. Watch our Medicare Supplement Insurance Plans Video to learn more.
What are the differences between a Medicare Advantage plan and a Medicare Supplement plan?
The biggest differences between Medicare Advantage and Medicare Supplement plans are network and cost. Medicare Advantage plans are HMOs or PPOs where you have a network of doctors and hospitals to choose from for your care. Medicare Supplement plans allow you to go to any doctor or hospital that accepts Medicare. Medicare Advantage plans offer low or $0 monthly health plan premiums beyond what you pay for Medicare Part B. Medicare Supplement plans supplement your Original Medicare benefits. To view a list of Medicare Supplement plans and their monthly premium costs, visit the Medicare website. Watch our Medicare Supplement and Advantage Plans Video to learn more.
I heard there is a penalty if I have had Medicare Parts A and B, but no Part D drug coverage. Is that true?
If you have Medicare, but have not had Medicare prescription drug coverage, or other creditable prescription drug coverage (such as from an employer or union, which is expected to pay, on average, at least as much as Medicare's standard prescription drug coverage) for any continuous period of 63 days or more after your initial enrollment period is over, you may owe a late enrollment penalty.
The late enrollment penalty is calculated by multiplying 1 percent of the "national base beneficiary premium" ($34.10 in 2016) times the full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $0.10 and added to your monthly Part D plan premium. The national base beneficiary premium may increase each year, so your penalty amount may also increase each year. In general, you'll have to pay this penalty for as long as you have a Medicare drug plan. Watch our Medicare Part D Video to learn more.
What should I consider when choosing a Medicare plan during open enrollment?
When you are evaluating your coverage options during open enrollment, it is important to look at the number of times you visit the doctor in a year, the plan benefits and monthly premium, the relationship with your current doctor, hospitalization cost, is drug coverage include in the plan you are considering or do you need a Part D plan and any additional services that are important to you like fitness, dental or worldwide coverage. Watch our Medicare Open Enrollment Video to learn more.
Do I need to enroll in the health insurance exchange, Covered California?
If you have Medicare, you do not need to worry about the open enrollment period for Covered California. Medicare beneficiaries are not eligible to purchase insurance through Covered California.
We are here to help you get answers to your Medicare questions. If you would like to learn more, contact us at 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 7 am to 7 pm. Watch our Medicare videos to learn more.
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