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Sharp Health News

It’s time to review your Medicare options

Sept. 2, 2021

Man speaking to pharmacist

Financial advisors suggest reading your will or trust each year on your birthday to ensure that your wishes are adequately expressed or to make changes, if need be. Medicare offers enrollees the same opportunity. It’s called the annual enrollment period and beneficiaries can make changes from October 15 through December 7 each year that will go into effect the following January 1.

Reasons for changing Medicare plans
Why change plans? Well, there are many reasons why a beneficiary might want to review and change their present plan, for example:

  • A change in residence
  • A change in prescribed medications
  • They want to have access to their local hospital or a specialist
  • Their income has changed or leveled off from the working wage to retirement income
  • Their present plan doesn’t offer additional benefits
  • They may benefit from a lower cost plan

Original Medicare does not cover all health-related costs. Beneficiaries are encouraged to obtain an additional plan for prescription drugs or face a penalty. If your prescription drugs change, you need to wait until the annual enrollment period to upgrade your policy to cover the new drugs.

Additional coverage for specialty and out-of-town care
Medicare Supplement Insurance, also known as Medigap plans, can also be added on to Original Medicare to help pay for some of the costs not covered. For instance, some people split the year between two residences. These plans are portable, meaning that they move with you, so they might be a good alternative. A Medigap plan might be an option if a beneficiary needs health care services in another county or a “super-specialist” in another health care system.

However, most Medigap plans do not have the additional benefits available to Medicare recipients, such as fitness, dental and vision. And these supplements can have a costly monthly premium, in addition to the Medicare Part B monthly premium and the prescription drug plan premium. This pathway can be expensive on a monthly basis.

Medicare Advantage Plans
The alternative to Medigap plans to enhance Original Medicare benefits are the Medicare Advantage Plans. These plans are inclusive — they include prescription drugs, fitness programs, hearing, vision, dental and more. Medicare Advantage Plans offer members coordinated care through a network model. Medicare Advantage Plans also offer worldwide emergency services. The famous red, white and blue Medicare card is not accepted worldwide, only in the United States and U.S. territories.

Medicare Advantage Plans offer the most services for the cost. In fact, many Medicare Advantage Plans accepted by Sharp HealthCare have $0 monthly premiums, including prescription drugs. With these $0 premium plans, the only monthly premium a beneficiary will pay is the Part B premium, which normally is deducted from the Social Security check.

The annual enrollment period is a good time to review your Medicare plan and benefits. Sharp HealthCare offers free virtual classes. Register online or call 1-800-82-SHARP (1-800-827-4277).

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