by Rob Tolle, Prominence Health Plan
Most people are aware that when they turn 65, they become eligible for Medicare. However, what people don’t always understand is that there are options available beyond Original Medicare – the healthcare benefits you receive from the government.
Medicare’s Annual Open Enrollment Period (AEP)— the only annual time of year when a Medicare beneficiary can make changes to their current coverage— starts October 15 and runs through December 7. With AEP nearing, it is important for individuals 65+ to know how to navigate their healthcare options.
Medicare is the primary insurer for Americans over 65 years old or for those with a qualifying disability. As mentioned above, there are other options outside of Original Medicare that offer additional benefits, such as Medicare Advantage plans which are an underutilized way to save money on healthcare costs.
With so many options to consider, we have outlined a roadmap on how to get started with Medicare and how to find the best plan for your lifestyle and health needs.
How to Get Started: All individuals 65+ can register for Medicare through Social Security. If you are already enrolled with Social Security, you will automatically receive Medicare Parts A and B when you turn 65.
You have a seven-month period to enroll in a plan, with the window starting three months before the month you turn 65, the month you turn 65, and the three months after you turn 65. For example, if you turn 65 in April, you can file anytime from January 1 to July 31. We recommend you register within the first three months of your eligible period to ensure you have health coverage when you turn 65.
Choosing a Plan: Once you are registered with social security, you will automatically receive Original Medicare, which includes your Parts A and B. These two plans only cover medical and hospital costs. You can also enroll in your Part D plan, which is your prescription drug coverage.
Since Original Medicare is automatically given to those who enroll in Social Security, many are unaware that you can enroll in a Medicare Advantage plan, the Part C “all in one” alternative to Original Medicare, which combines Parts A and B, and usually includes Part D. These plans keep all of the medical coverage offered under Original Medicare and they often include additional benefits not covered by Original Medicare like dental, vision, hearing, and transportation to doctor’s offices. These plans typically set a maximum out-of-pocket, whereas Original Medicare has no cap on your out of pocket expenses.
It is important to note that Medicare Advantage plan benefits change every year. If you currently have Medicare Advantage, now is a good time to evaluate your options to ensure that you’re enrolling in a plan that best works for you.
Evaluating Your Current Plan: Every year from October 15 to December 7 there is an Open Enrollment Period, where anyone who is Medicare eligible can review their benefits and elect to join or switch to a different company or plan. Coverage with the new plan will begin on January 1, as long as the plan receives your application by December 7.
You can review all plans available in your county by going to Medicare.gov. From there, you can compare plans to determine which is best for your individual needs.
As we are navigating a pandemic, it is especially important to evaluate options and plans. It can also be helpful to bounce around your ideas with someone who sees all of the angles, which is why we advise talking with a licensed insurance broker who can provide unbiased information to help you find a plan that fits your needs.
PLEASE NOTE: Featured image is of the Prominence Health Plan Team promoting AEP in 2019. Hence, no masks.
Rob Tolle leads a team of licensed brokers located in Reno who can compare available plan options throughout Washoe, Carson City, Douglas, Storey, Lyon, and Churchill counties.
To evaluate your current plan or learn more about your options, call 800-880-7457, Monday-through Friday from 8AM-8PM.