There are more than 55 million Americans covered by Medicare, including approximately 215,000 Mainers (or almost 25% of the State’s population). Every year, Medicare offers an open enrollment period allowing new enrollments, or current recipients to make changes to their plan. Medicare is not a one-size-fits-all program, and in fact it offers a large variety of choices that people can elect to put together the best combination of benefits for their needs and budget. People need to realize that enrolling in Medicare can be complicated, and if you don’t pay attention you can end up missing needed coverage or paying more out-of-pocket expenses in premiums, co-pays and deductibles than you realize– or can afford.
Open Enrollment runs every year from October 15- December 7. Whether you are joining Medicare for the first time or thinking it’s time to make changes to your current plan, here is helpful information everyone needs to know:
- You have two primary forms of Medicare coverage to select: Original Medicare that you qualify for automatically or private Medicare Advantage Plans.
- Medicare Advantage Plans are managed by health insurance companies for the cost of monthly premiums offering additional services and usually Part D Prescription plans.
- Medicare Part A pays for hospital and SNF based rehabilitation based care.
- Medicare Part B pays 80% of costs for doctors, outpatient services, and medical equipment.
- Medicare Part C is a private Advantage Plan.
- Medicare Part D pays for prescriptions.
- Medicare Supplemental Insurance (Medigap) is private insurance that pays gaps in the varieties of Medicare coverages.
Assistance is available to help people understand and navigate enrollment. Agents who specialize in Medigap and Medicare Advantage Plans can help with initial enrollment and open enrollment. Free assistance can also be obtained through the State Health Insurance Assistance Program (SHIP) and the Medicare Rights Center. Also, the Center for Medicare and Medicaid Services (CMS) website (www.cms.gov) provides a wealth of information and resources to review and assist enrollment. It is important to not wait until the last minute. When it comes to Medicare enrollment, not being informed and missing deadlines can cause delays and penalties that could have a negative impact on your coverage—and your wallet.