Medicare Do's and Don'ts

Tue, Nov 10, 2020 9:18 PM Medicare

Start with this list of basics to help lead you down the path if you're on the road to choosing a Medicare plan. 

DON'T wait to sign up

Beware of the penalty for not enrolling when first qualified in Part B and Part D. You get trapped indefinitely with fines, "whether you have credible coverage from your current employer or the current employer of your spouse." 

The penalties are:

• Part B (medical services for doctor visits and outpatient treatments): For any 12-month span you should have been compensated but were not registered, the premium would go up 10 percent. For life, these higher premiums apply. 

As for Medicare Supplement Insurance (also called Medigap), you can not be denied coverage if you apply when you are first eligible for Medicare at age 65. You might not be eligible to apply for coverage later if you delay, or the cost of the coverage may be much higher.

DO consider whether you want to keep your doctor

If your doctor is important to you, before choosing a Medicare plan, speak to him or her. Not all physicians accept Medicare, but it's great to know that it's improving. Make sure your doctor is part of the network if you are considering a Medicare Advantage Plan that provides in-network coverage.

 

Also Read : The Easiest Way to Cut your Medicare Drug Costs

 

DON'T Depend on the experience of a friend

Listening to ads or asking a friend for advice is appealing and so easy, but choosing a plan that way is not wise. A safer approach is to take the time to analyze the details of various proposals carefully.

For each package, look at the coverage specifics, and how they will operate. A Medicare benefit broker representing several different carriers will be a good source of information, as will the State Health Insurance Assistance Program (SHIP), which decisions will impact you long-term, such as not enrolling at all or selecting the wrong Medigap plan, for instance,  versus which ones can be altered during annual open enrollment (the particular open enrollment).

DON'T presume that everything is covered

A major expectation is that long-term care expenses will be covered by Medicare. It won't, which could leave some seniors financially in a really tight position. Nursing home care, dental, vision, hearing, and complementary treatments are also not usually provided by Original Medicare.

DON'T presume that you will sign up automatically

You will automatically be enrolled in Original Medicare (Parts A & B) when you turn 65, if you are not earning Social Security benefits, and will receive your Medicare card in the mail three months before your 65th birthday. The coverage starts on the first day of your birthday month.

If you do not obtain Social Security, though, you will have to enroll during a seven-month eligibility cycle that includes the three months before your 65th birthday, your 65th birthday month, and the following three months.

Based on the drugs you take, DO choose a prescription drug plan

It is important to ensure that the prescription drug plan that you are interested in covers all your drugs. There is a list called a 'formulary' for each prescription drug plan, which tells you which medications are covered by that plan. Often, under the plan, you'll want to know the cost of those drugs. Everyone has different medication criteria, so it is important that enrollees go through the process of entering their individual prescriptions into a plan finder tool and then search at each plan to see the overall out-of-pocket estimate. 

Picking the lowest-cost plan option is probably a smart bet if you don't take any drugs at all. You will have an option to change plans periodically, but you would escape a late enrollment penalty that would otherwise happen if during your initial enrollment period you opted out of Medicare Part D entirely.

Don't believe that the original Medicare coverage is enough.

Original Medicare coverage consisting of Part A, hospitalization, and Part B, medical appointments, and outpatient treatments is ideal for certain individuals. Part A and Part B, however, have limits on coverage. You won't have any allowance for outpatient prescriptions. If you stick with only Original Medicare, and you won't have any limit on your out-of-pocket expenses, which can be troublesome if you need a lot of treatment.

You would still need to select a Prescription Drug Plan if you're looking at Original Medicare. And if you're looking for coverage that restricts your expenditure, look at Medicare Supplement / Medigap plans that don't cover the original 20 percent of Medicare. You should also look at Medicare Advantage Plans, which provide $6,700 annually for in-network coverage and cap costs.

 

 

Related Articles:

Common Myths and Misconceptions about Medicare

Things To Avoid During Medicare Open Enrollment

 

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