MEDICARE ADVANTAGE OPEN ENROLLMENT RUNS THROUGH MARCH 31, 2019
Original Medicare vs. Medicare Advantage Oversimplified
Before making changes, it’s important to distinguish between original or traditional Medicare and a Medicare Advantage plan. Original Medicare is provided by the federal government and covers some of the costs associated with hospital stays (Part A) and doctor visits (Part B). But it doesn’t cover everything. It does not include prescription drug coverage (Part D). Although enrolling in Part D is not a requirement, there is a one percent penalty of the average monthly premium for each month enrollment is delayed. This must be paid monthly, as long as the individual is enrolled in Part D.
To this end, Medicare experts sometimes recommend a supplemental policy to cover additional overlays like deductibles and copayments. Original Medicare does not cover prescription drugs, or vision and dental costs. Additionally, original Medicare has no annual out-of-pocket maximum. For more information about what original Medicare covers, who is eligible, and other pertinent information, visit Medicare.gov.
Medicare Advantage (Part C) plans are designed differently. These plans include Part A, Part B, and in many instances, Part D. MA plans are written through private insurance companies, and some include $0 monthly premiums. Dental and vision coverages are offered in some plans. MA plan benefits may change from year to year, and enrollees are often required to be seen by in-network doctors or pay more. In other instances, plans allow enrollees their choice of doctor in- or out-of-state, and even in other countries.
Some MA plans offer free ancillary benefits like Silver Sneakers, a monthly stipend to order health-related products, as well as other benefits. These perks will differ from one MA insurer to the next. MA plans come with annual out-of-pocket limits. For more information, visit Medicare.gov and speak with an insurance broker.
There’s Still Time to Make that Switch
Here’s what you can do during MA open enrollment (remember, it only runs through March 31, 2019):
- Change from one MA plan to another
- Opt-out of a MA plan and switch to original Medicare
- Elect a stand-alone Part D prescription drug plan if prescription drug coverage is lost due to opting out of a MA plan.
- Coverage is effective the month after making the switch.
Here’s what you can’t do:
- Switch from original Medicare to a MA plan.
- Switch from one prescription drug program to another if enrolled in original Medicare.
- Join a prescription drug plan (Part D), if originally enrolled in Medicare and previously declined to enroll in a Part D plan.
- Centers for Medicare and Medicaid Services – medicare.gov
- 1-800-MEDICARE (800-633-4227)