GUIDE TO MEDICARE: Time to shop around to make the right moves

According to the Kaiser Family Foundation, a non-profit organization that analyzes health policy, only 10% of the 59 million Medicare beneficiaries make a change during the Open Enrollment period. Not reviewing your Medicare options can have a significant effect on out-of-pocket costs, plus access to medications and medical care.

Now’s the time to take action. During the Fall Open Enrollment period of Oct. 15 through Dec. 7, beneficiaries can change their coverage without incurring penalties. Options include selecting a new plan, revising drug coverage or switching to an Advantage plan. Changes go into effect on Jan. 1, 2019.

Then, survey available plans in your area and decide between Original Medicare, which two-thirds of beneficiaries select, and a Medicare Advantage plan.

Original Medicare is comprised of Part A (in-patient hospital stays, skilled nursing facilities, hospice centers, limited home visits); Part B (physician visits, preventative care services, limited home health; and Part D (outpatient prescription drugs). The benefit of this plan is access since most doctors, hospitals and health care providers accept Original Medicare.

With Medicare Advantage, you select between private health plans. The benefit of these plans is bundled coverage, which can make care easier to manage and can reduce costs.

Fred Riccardi, vice president of client services at the Medicare Rights Center, a national, nonprofit consumer service organization, recommends this tried and true advice:

“If the beneficiary has Original Medicare and a supplemental Medigap plan and they are happy with that, then they do not need to change it,” he says.

“Older adults are typically bombarded with plans at this time of year and they can find it to be overwhelming. If they have prescription Part D or an Advantage plan, they should review that, too. Plans can and do change their coverage from year to year and it’s important that people consider their options.”

For those with a Medicare Advantage plan, Cubanski also recommends doing a careful comparison.

When evaluating options, experts recommend shopping around to find a plan that best meets your needs and finances. “Some people look at monthly premium as a good enough indicator, but it’s really important to look beneath that to the deductible, network access and whether drugs are covered or not,” Cubanski says.

Help is a click or call away

More information on financial resources can be found at www.medicare.gov or www.health.ny.gov.

Call 1-800-Medicare to speak to a representative and review your plan choices with you over the phone.

Schedule an in-person appointment at a State Health Insurance Assistance Program (SHIP), known as HIICAP (the Health Insurance Information, Counseling and Assistance Program) in NY State at www.aging.ny.gov or 1-800-701-0501.

People outside of New York State can call 1-800-Medicare for assistance over the phone.

Call the Medicare Rights Helpline(1-800-333-4114) or visit medicarerights.org, which is run by the non-profit Medicare Rights Center.

For a comprehensive overview of Medicare and Medigap, visit the Kaiser Family Foundation website at www.kff.org.

Apply for Medicare at www.ssa.gov or visit your local Social Security office.