There are times when you are still being covered by another insurance plan and can enroll in Medicare and the like that you will want to delay a part of Medicare from starting. You don’t want to be paying two separate premiums, which is exactly what you would be doing if you didn’t delay the coverage. The question is, when you delay Part B coverage can you do so without paying higher premiums?
There are two situations in which you could delay enrolling in Part B of Medicare without paying higher premiums when you were first eligible. For the following to occur you must have been on you or your spouse’s plan and had group coverage through one of the entities. Here are the two ways in which you could enroll without the penalty.
Anytime you are still covered by the employer or union group health plan through your or your spouse’s current or active employment, or you are in the following situation.
During the 8 months following the month the employer or union group health plan coverage ends, or when the employment ends (whichever is first). The “whichever is first” part shows the concern by Medicare that you and your family are being taken car of first.
Right now we are in the middle of open enrollment for Medicare. Open Enrollment will last until December 31, 2008, and it is important that you know as much as possible about Medicare coverage so that you can make good choices for the next year.
Medicare and Medicare Supplements, also called Medigap, have a number of parts and they are not always easy to figure out. In fact, determining how all these parts fit together and what you need for your situation can be totally confusing. This brief overview will give you information on the basic parts of Medicare and what is covered by them.
Medicare Part A and B make up the original Medicare. Part A basically covers in-patient services including inpatient rehabilitation and inpatient psychiatric care. Many services are covered completely, but you will have to pay a co-payment for some of the others.
Part B covers your doctor visits and other outpatient services determined to be “medically necessary” for you. It also covers certain tests to determine if you have an illness. There is a deductible, which is $135 for the year 2008, and there are also some copayments with it.
Medicare Part C is also called Medicare Advantage. The Medicare Advantage Plans are not part of the actual Medicare system, but they work with it. Medicare Advantage is an alternative to Medicare and the plans are run by private companies. There are a variety of plans that all work differently. Some plans work as HMO’s others charge a Fee for Service allowing you to go to any doctor as long as the doctor will accept payment from Medicare as payment in full. It is very important to research and find out whether the Medicare Advantage Plan you are choosing will actually work with your medical needs.
Part D covers Prescriptions. These are covered by private insurance companies approved by Medicare. This coverage is important, and you must determine what type Part D coverage you need. You should figure out what you need in advance so that you can enroll immediately when you are eligible. If not, you will be charged a substantial late fee. If you enroll in a certain Part D plan and feel it isn’t right for you, every year you will have an opportunity to change between November 15th and December 31st which is where we are right now. If you need to change plans, now is the time to do it.
That was the easy part. Now for the Supplements – the Medigap policies. There are 12 policies that cover services that are not otherwise covered. Each supplement is different and covers different things. In addition, it is possible to purchase these supplements from private insurance companies, get them from you or your spouse’s employer or from various government programs.
All Medigap Policies are standardized and approved by Medicare. This means that for policies E on up the alphabet, each lettered plan offers the same coverage no matter what company you purchase it from. An insurance company can charge whatever they want to charge, so compare companies and rates carefully. That way you won’t buy from a company that charges much more as another company for the same coverage.
So, do your research and determine which Medicare Supplemental Insurance is the best for you and find the best price. If you need information, check the web at www.Medicare.gov.
Medicare used to be one basic program with very few – or no – variables. You got what you got, it paid what it paid, the doctors were pretty familiar with it and so were Medicare recipients. Sometimes the payment was slow getting to the doctors, but everyone knew that was how it was and simply lived with it.
Fast forward to today. There is still a basic Medicare program; however there are a total of 57 prescription drug programs (Part D) that a recipient could ask for. Any combination of them could work for a recipient; however, there is usually one combination that will work best. Supposedly, the way to find that combination is to go onto the Medicare website at www.medicare.gov and type in all of your prescriptions where asked. At that point, you should receive a plan recommendation that is best for you.
The problem is that there is no way to be sure. It is essential that you sign up for Medicare Part D when you are ready to turn 65. Do your research in advance, because you have only three months after your 65th birthday to sign up for Part D. In addition, you have the right to refuse Part B which covers , but experts say that it is not wise to do so. L Though it costs $96 per month and comes out of your Social Security check each month, it could cost much more if you had to pay the cost of the medical bills it covers out of your own pocket.
In some states and counties, such as in southern Oregon, there are meetings being held to discuss Medicare and unscramble what means what. There are organizations with volunteers in Oregon to help you understand – in plain, understandable English – exactly what is covered and exactly what you need.
Dick Heintz of Senior Health Insurance Benefits Assistance (SHIBA) will be facilitating workshops in Oregon. This is important information for you to know. If you are in areas other than southern Oregon and need information, go to www.medicare.gov.
