Healthy Living

Medicare – 4 Questions For Choosing the Right Plan

The Medicare annual open enrollment period is in full swing now through December 7, 2016. Choosing the right Medicare plan is a big decision and can be overwhelming.

You can begin the process by asking yourself these 4 simple questions:

  • Are the drugs I’m currently taking covered by this plan?
  • What is the plan’s Star-Rating? Is it a four or higher?
  • How much is the monthly premium (remember, a lower premium might mean fewer offerings)?
  • Will I have 24/7 pharmacist support?

Once you’ve answered these questions, you can move on to exploring the two main routes in Medicare coverage: Original Medicare or a Medicare Advantage Plan (Part C). Both routes include Part A (inpatient hospital care) and Part B (medical insurance) coverage. You’ll need to call Social Security directly, to make sure you can sign-up (and are eligible) for Parts A and B.

Here are some things to keep in mind when exploring these two options:

Consider Original Medicare and a Stand-Alone Part D (prescription drug ) Plan If You:

  • Are interested in access to a larger network of health providers and facilities
  • Have supplemental coverage from an employer to cover some costs and services (not covered by Medicare)
  • Are comfortable coordinating coverage from multiple providers
  • Can buy a Medigap policy from a private company to help pay some of the costs that Original Medicare doesn’t cover, like copayments, coinsurance and deductibles

Consider a Medicare Advantage (Part C) Plan If You:

  • Like the convenience of having just one provider without having to communicate with multiple providers
  • Prefer a plan that is similar to what you may be used to from past coverage (e.g., employer)
  • Want to purchase a plan that covers services not available through Medicare (i.e., vision, dental, hearing plans)
  • Are willing to use in-network doctors and medical facilities like in an HMO or PPO
  • Are only looking for coverage within the United States

After you select the route that’s best for you, consider the following to ensure nothing takes you by surprise – especially higher costs.

Enroll in Medicare On Time

Don’t procrastinate! Once you’re eligible for Medicare (Part A, B or D) it’s important to do your research early and sign up during your initial enrollment period (or when first eligible) to avoid unnecessary penalties.

Each part of Medicare has a different way to determine the penalty, so it’s important to know how a delay will impact your costs in the future. Take a look at this article, to better understand how the penalties work.

Evaluate Part D-IRMAA

Some people are faced with something called the Part D Income-Related Monthly Adjustment Amount (IRMAA) premium, which is based on the income you reported on your taxes for the last 2 years.

If your income was greater than $85,000 annually as an individual (or married and filing separately) or greater than $170,000 as a married couple filing jointly, you will have to pay a Part D – IRMAA premium. The current minimum Part D – IRMAA premium is $12.70 per month, while the maximum is $72.90. These premium costs increased about 3% in 2015. However, they won’t change again until 2019, when they’ll be adjusted for inflation.

Social Security will automatically deduct this premium from your monthly benefit check if there is enough money to cover the amount. Find out more information about Part D – IRMAA here.

Reevaluate Your Plan Every Year

Plans may change each year. Your current plan’s premium, deductible and copayments/coinsurance may rise this year, while another plan may offer lower premiums or copays. In fact, a recent study estimates that beneficiaries who stay with their current prescription drug plan will pay, on average, a 13% premium increase.

Do your homework to ensure your plan is still the best option for meeting your prescription drug needs – this may save you hundreds of dollars in the long run This enrollment period, begin your research on other plans by checking the plans’ websites, calling for information or requesting plan materials to review. This is your time to ask questions and ensure you have the right plan in 2017.

For more tips and information about Medicare Part D, visit www.RoadmapForMedicare.com.

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