Medicare is the government health insurance program currently serving more than 55 million Americans. Many seniors rely on this coverage but, did you know, this is not a one size fits all program? Medicare comes with a variety of coverage options, particularly relating to Medicare Advantage and Part D prescription drug coverage. Making the right choice can not only save hundreds, maybe thousands, of dollars a year, but it also means securing the best available health coverage for your specific needs. 

Right now, we are in the Medicare Annual Open Enrollment Period. This is the time of year that Florida seniors may choose to enroll or change their health care coverage. As experienced estate planning and elder law attorneys, we know Medicare can be confusing and we would like to provide information and guidance on this important topic. One of the first things to do when you are re enrolling, or enrolling for the first time, is to decide whether you want “Original Medicare” or a Medicare Advantage plan. Let us share three key tips for you in our blog.

First, learn the language. Original Medicare has two parts: Part A, which provides coverage for most costs related to hospital stays, and Part B, which covers medical services, like doctor visits, lab work, and preventive care. Part A is usually free, but Part B comes with a monthly premium cost. The standard premium price for 2018 was about $134 a month. Medicare Advantage plans offer Part A and B coverage through private insurers.  Unlike Original Medicare, however, these plans are restricted to a network of health care providers that may not include your current doctor. If your doctor is out-of-network, higher costs can apply. This is a major consideration when choosing the best Medicare fit.

Second, plan for the costs early. There are also financial differences to consider. For example, Medicare Part A can cover the full cost of the first 60 days of a hospital stay, but in most instances a deductible applies for each hospital visit. In 2017, the average cost was $1,316 per visit. Another expense for Original Medicare Part B enrollees is the standard 20 percent copay for doctor visits and other related medical expenses.

Purchasing supplemental Medicare insurance, such as Medigap, may help cover the above mentioned costs. Medicare Part D prescription drug coverage is another area to evaluate. It can be purchased as either a stand-alone plan in conjunction with Parts A and B, or it may be included in a Medicare Advantage plan. In either case, prescription drug coverage will run through a private insurer. This means monthly premium costs apply, about $33.50 per month in 2018, and variation in covered drugs and prices, depending on where you live and your specific plan.

Third, remember, options and prices can also change year to year. Do not wait to reevaluate your Medicare plan. You are able to make changes and choose a different plan, without penalty, during Medicare’s annual Open Enrollment Period from October 15th through December 7th.

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