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Have a Medicare Advantage or Part D Prescription Drug Plan? If So, Be Ready for the Upcoming Annual Enrollment Period

2015-annual-enrollment-period

The annual enrollment period for Medicare is coming up soon. It will start October 15, and end December 7. To supplement your health insurance, you can choose from a Medigap plan and a Part D plan, or you can replace traditional Medicare with an Advantage plan.

The annual enrollment period does not affect Medigap plans. But it does give you a small window of time when you can sign up for a Medicare Advantage plan or a Part D prescription drug plan guaranteed issue – even if you have pre-existing health conditions.  

Traditional Medicare

Traditional Medicare is offered through the federal government. The advantage of traditional Medicare is that you don’t need a referral to see a specialist and you can supplement your costs with a Medigap plan. You can learn more about Medigap plans and Part D here. If you go with traditional Medicare, these are the rules:

  •     If you enroll in both Part A and Part B, you get hospital and medical coverage.
  •     You can go anywhere where Medicare is accepted.
  •     You pay a deductible and/or coinsurance.
  •     You likely pay a monthly premium for Part B.
  •     If you have at least 10 years of United States work history, there is no premium for part A.

Medicare Advantage

Medicare Advantage plans are sold through private insurance companies. They must cover the same benefits as in traditional Medicare’s part A and B. Some Medicare Advantage plans also offer vision and dental.

The benefit of a Medicare Advantage plan is that all plans must have a yearly cap where you don’t have to pay out-of-pocket anymore, and most plans include vision and dental.  These plans are also usually much less expensive than a Medigap plan. To learn more, visit www.MediGapAdvisors.com/AEP. The general rules are:

  •     You pay a deductible and copay.
  •     You must use doctors/specialists in the plan’s network.
  •     You can’t buy a Medigap plan.

Which One is Better?

In terms of whether traditional Medicare supplemented with a Medigap policy and a Part D prescription drug plan is better than Medicare Advantage depends on your needs.

If you value the ability to choose your own doctor, and want to keep your out-of-pocket costs to a minimum, a Medicare supplement and Part D plan is probably going to be the best choice.

If you don’t mind choosing from doctors within a specific network, and want to keep your monthly premium to a minimum, you may want to consider a Medicare Advantage plan. Look for an MAPD plan so that your Part D coverage is also included.

Taking Advantage of Open Enrollment

Anyone who takes prescription drugs should have a Part D plan, or a Medicare Advantage plan with Part D included. Part D plans typically do not cost very much. If you are already on a Part D plan, you should have your agent reevaluate your plan if your drugs have changed. You could save on out-of-pocket costs.

If you are on a Medicare Advantage plan, this is your once-a-year opportunity to shop around and see if you can find a better value, especially if your rates have gone up. If you do sign up for a new Medicare Advantage or Part D prescription plan, your new coverage will go into effect January 1st.

And finally, if you are on original Medicare without a supplement, and currently have health problems that might prevent you from qualifying from a Medicare supplement plan, signing up for a guaranteed-issue Medicare Advantage plan is a great way to make sure there is a cap on your out-of-pocket costs if you ever face major medical bills.

 

 
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