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Trout Insurance Blog

What you need to know for Medicare Open Enrollment

10/18/2018

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If you’re approaching the age of 65, in addition to considering life without an alarm clock, you need to consider your health insurance options very carefully.  A form of Medicare most likely will be your main health insurance.
Because there are so many options, it can be complicated.  I’ll break the basics down and share some resources to help you make the right decision.
Don’t wait to think about your options!  When you turn 64, here is a great month by month checklist  of things to consider.






THE BASICS 
  • Medicare is a federal insurance program. To qualify you must be 65+, under 65 with a disability or have an end-stage renal disease.
  • According to Medicare.gov, if you don’t enroll when first eligible you may pay a penalty and have a gap in coverage. An exception to this is if you have other credible coverage like a health insurance plan from your employer.
  • You can keep Original Medicare only (the Federal program) and in addition, you may purchase a Medicare Supplement plan to help with the copays and deductibles that Original Medicare does not cover.
  • You can replace Original Medicare with a Medicare Advantage plan (from a private insurer who has a Medicare contract to administer benefits). Many do this because of the additional options they offer.
  • This year’s open enrollment to purchase a Medicare Advantage or Part D plan (prescription drug coverage) is Oct. 15 – Dec. 7.


THE OPTIONS
MEDICARE PART A AND B PLANS (ORIGINAL MEDICARE)This is what we call original Medicare which the government administers.  The premium is deducted from your monthly social security check.
  • Medicare Part A covers inpatient hospital stays, skilled nursing facilities, hospice care, and some home health care.
  • Medicare Part B covers certain doctor services, outpatient care, medical supplies, and preventive services
You will not have copays but will be required to pay coinsurance. Medicare will pay 80 percent of the medical expenses approved by Medicare while you will be responsible for the remaining 20 percent.
Original Medicare does not cover most prescription drugs or other services private insurers may offer.
MEDICARE SUPPLEMENT (MEDIGAP)A Medicare Supplement (Medigap) policy is an additional option when purchasing Original Medicare. It’s sold by private insurers and helps pay some or all the health care costs that Medicare doesn’t cover, like copayments. coinsurance. deductibles. 



MEDICARE ADVANTAGE PART C PLANSThis type of plan is administered by a private health insurer. These plans, in addition to offering everything Original Medicare provides, offer additional features and benefits that you may not get with a Medicare Supplement plan.Most of these plans include prescription drug coverage and have in-network doctors. You would pay your premium directly to a private insurer and maintain lower out of pocket costs if seeing network doctors.
When selecting a Medicare Advantage Plan you would still be required to pay your Medicare Part B premium, normally deducted from your social security check.
MEDICARE PART D (PRESCRIPTION DRUG COVERAGE)This type of plan is administered by a private health insurer. Medicare Part D is a standalone prescription plan that helps cover your prescription needs and is typically paired with a Medicare Supplement plan. Many Medicare Advantage plans have Part D drug coverage, but there are some that offer medical benefits only.  You are not allowed to have both a Medicare Advantage plan and a stand-alone Part D drug plan.

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  • Insurance
    • Home & Auto Insurance
    • Medicare
    • Income Protection >
      • Disability Insurance
      • Long-Term Care
      • Critical Illness
      • Annuities
    • AARP - Hartford
    • Life Insurance
    • Health Insurance
    • Dental, Vision, Accident >
      • Cigna Dental, Vision, & Hearing
    • Employee Benefits
    • Business Owners >
      • Group Health Insurance
      • Commercial Property & Liability
      • Business Overhead Expense Disability
      • Disability for Business Owners
      • Critical Illness
    • Short Term Health
  • Trout Team
    • Our Story
    • Dave Trout
    • Jessica Cody >
      • Home & Auto Insurance
    • Jeremy Sheridan
    • Robert Pugh
    • David Hanson
    • Jennifer Trout
    • Idelle Davids
    • Jan Trout
    • Steve Dillingham
  • Resources
    • Employee Success
    • Fixing the ACA "Family Glitch"
    • Aetna/CVS Health NC
    • Client Center
    • Reviews
    • Blog
    • Articles >
      • Health Insurance 2022
      • Friday Health
      • Comparing 2022 Plans
      • Insurance Partners
      • Best Value Insurance Plans
      • ARP Facts CMS
      • ARP Unemployment
      • ARP 2020 Excess Premium Subsidy
      • No Income Cap
      • Unemployment Glitch
      • Asheville Homesharing
      • 2019 Verification-a
      • BCBS Online Setup
      • APTC Income 2023 & Tax Form 1040
      • Lost Subsidy
      • Privacy Policy
  • Community
    • Alignment Town Hall
    • Employer Networking w/ Just Economics
    • FALLing with Families
    • Medicare New Era Event October 13th
    • Blue Ridge Pride Festival
    • Health & Wellness Fair
    • Goombay & YMI
    • Alignment Health Plans
    • YMI Winter Coat Drive
    • Medicare Seminar
    • Art in Autumn + MANNA
    • Music on Main
    • Western Women's Business Center Conference
    • Mural on Main Street
    • Expanded Team- Next Generation
    • Back to School
    • Weaverology
    • Mother Earth Food
  • Contact Us