Medicare Open Enrollment season started on October 15th and goes through December 7th. If you have traditional Medicare (Parts A and B), this is your annual opportunity to change or switch your Part D Drug plan, sign up for a Medicare Supplement (MediGap) or switch to Medicare Advantage. If you are on Medicare Advantage, you can change your plan or switch to traditional Medicare. This is the only time of year that you can make there changes
Here’s where you can find the 2019 Medicare Parts A & B Premiums and Deductibles. Medicare Part A covers inpatient hospital, skilled nursing facility, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment. Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.
Medicare Advantage is continuing to grow and has doubled since 2010; increasing from a quarter of Medicare beneficiaries to more than a third. Centers for Medicare and Medicaid Services anticipates a 12% enrollment increase this year. The number of available plans in 2019 has increased to 3,700 from 3,100 just a year ago. For more on this, see: Medicare Advantage Riding High As New Insurers Flock To Sell To Seniors.
The reasons for the increasing enrollments are that Medicare Advantage plans offer vision, hearing aids, dental care, drug coverage, overseas car, podiatry and cosmetic surgery along with this year being able to offer other health related benefits such as adult day care and home-home-health aids along with premiums that are decreasing by an average of 6% in 2019 according to the CMS. However, there are reasons to proceed with caution……
Factors to consider when choosing a medicare plan:
- Do you want to keep your current medical service providers?
- Referrals to specialists (Original Medicare does not require a referral to a specialist while Medicare Advantage plans do require a referral).
- Do you have a pre-existing condition? If you have a pre-existing condition, you may not be able to switch from a Medicare Advantage plan to a Medigap plan. If you enroll in a Medigap policy, an insurance company can charge you a higher premium or decline coverage if it is after the initial six month window from when you enroll in Medicare Part B.
- What medications do you take regularly? If you are on Original Medicare, you will need to enroll in Medicare Part D for prescription drug coverage.
- Do you expect to travel either domestically or internationally? (type of network)?
- Do you spend time at a second home?
- Consider your total cost. This is the sum of your premium and expected/usual deductibles and co-pays. This is important as some Medicare Advantage plans have low premiums and high deductibles and copays (co-insurnace). Original Medicare does not have an out-of-pocket limit while Medicare Advantage policies do have an out-of-pocket limit.
- Medicaid eligibility (or other assistance programs?)
- Do you health insurance through your job or through your spouse’s job?
All the resources you need to get started on enrolling or making a change can be found on the official Medicare website. The Medicare Rights Center has an interactive tool that provides easy-to-use information about enrollment and plan options. And if you want state-specific details, the State Health Insurance Assistance Program (SHIP) can tell you more about offerings in your area. To find your state’s SHIP program, go to Shiptacenter.org or call 877-839-2675 to talk to a trained counselor.
Resource for Medicare and ACA Open Enrollment:
Visit tonysteuer.com to use the Find Your Optimal Insurance Deductible Calculator. The Optimal Deductible Calculator is designed to help you select the deductible that provides the most value for you. There is no set-in-stone formula for calculating your deductible; sometimes insurance companies will price in an “incentive” for a certain deductible, so determining your break-even point is always a good idea. Ask yourself whether the money you save in insurance premiums justifies taking on a higher risk, along with a higher deductible (and with health insurance, higher copays and coinsurance). The Optimal Deductible Calculator will calculate the additional risk that you are taking on and divide it by the annual savings to determine your break-even point (number of years to break-even).