5 Common Questions About Medicare, Answered
Did you just turn 65 or are you considering switching Medicare plans? If so, welcome to Medicare’s annual Open Enrollment period. From October 15 until December 7, you can enroll in a Medicare plan or switch to a different Medicare health or prescription drug plan.
Medicare provides affordable health coverage for adults age 65 and over, as well as for adults under age 65 who have a qualifying disability. If you want enhanced coverage, you can sign up for supplemental policies or a Medicare Advantage plan.
For all its benefits though, choosing a Medicare plan gets complicated. What does Part A and B cover? Do I need Part C? Does Part D cover my prescriptions?
To help you sort through these options, Blue Cross and Blue Shield of Nebraska is keeping their phone lines open seven days a week. From 8 a.m. to 8 p.m. CT, Oct. 1 through March 31, its experts will review your coverage and help you choose a new plan that fits your needs. Call them at 1-833-430-4643 today.
To help make your Medicare enrollment process even easier, we’ve put together a Medicare FAQ. For any additional questions, we’ve also included a few helpful resources.
What does Medicare cover?
To understand what Medicare covers, it helps to understand its parts. Original Medicare includes Part A and Part B. Part A covers hospital-related services: inpatient hospital care, skilled nursing facility stays, hospice care, and some home health care. There’s no premium for Part A because either you or your spouse paid for it out of your payroll taxes.
Part B covers doctor visits, outpatient care, some physical and occupational therapy and some home health care. Currently the premium is $135.50 per month if you earn $85,000 per year or less. It may increase in 2020.
Part D covers prescription drug costs. It’s available to any Medicare beneficiary. You have to apply for Part D separately and pay a separate monthly premium.
Medicare Part C, aka Medicare Advantage, includes Part A and B coverage. Some Medicare Advantage plans also provide coverage for vision, dental, hearing and fitness benefits.
To add to the choices, you can also opt for a Medicare Supplement policy. Also called Medigap, Medicare Supplement plans provide Part A and B benefits through Original Medicare. They also cover out-of-pocket costs such as copayments and deductibles.
What should I consider when selecting a plan?
Make sure your current doctors and specialists are in a plan’s network. Original Medicare has no network restrictions on physician and specialist choices. But it also has no annual out-of-pocket limit. If you have significant medical expenses, you may save money with a Medicare Advantage plan. These plans limit out-of-pocket spending.
Does Part D cover my prescriptions?
Every plan that offers drug coverage through Medicare Part D has to provide at least a standard level of coverage outlined by Medicare. From there, health insurers can vary the list (called a formulary). They can also divide that list into tiers, offering different copays for different types of drugs.
Make a list of your current and, if possible, future medications to verify coverage. Review each drug in your insurance plan’s formulary to make sure it’s covered in 2020. If you’re shopping for a new plan, you can use Medicare.gov’s Plan Finder to compare several prescription drug plans.
When you’re researching, think about how you fill your prescriptions. Medicare Advantage plans have preferred pharmacy networks and may offer lower copays with mail order services. Additionally, look to see if plans have added benefits for over-the-counter medications, such as vitamins, pain relievers and cold remedies.
I like to travel. Does that matter?
Yes, it does. If you plan to travel, choose a program that offers coverage outside your home state. Medicare Supplement plans offer nationwide coverage; they’re accepted everywhere Original Medicare is accepted. Some Medicare Advantage plans offer coverage for travel outside of the service area. All plans have emergency and urgent care coverage domestically and internationally.
How do I choose?
For more immediate assistance, call Blue Cross and Blue Shield of Nebraska at 1-833-430-4643. A health insurance expert will help you sort through the differences between Medicare Parts A, B, C and D, as well as Supplement plans, to find a combination that fits your unique needs.
To compare prescription drug plans, Medicare Advantage Plans, and Medicare Supplement plans, use Medicare.gov’s Plan Finder. You can review benefits covered, deductibles, copays and premium costs to find what you need at a price you can afford.
You can also call your State Health Insurance Assistance Program (SHIP). These programs offer in-person counseling for Medicare beneficiaries and their families to help you make an informed decision.