Medicare Open Enrollment

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Question: I’m currently enrolled in a Medicare Advantage Plan and was told that I should switch to traditional Medicare, I am getting overwhelmed with all of the choices and options.

Answer: Fall Open Enrollment for Medicare begins on October 15 this year and will last until December 7th.   During this time period those who are enrolled in Medicare can make changes to their health plan and prescription drug coverage without penalty.  During this time those who are enrolled in a Medicare Advantage plan can switch to traditional Medicare, and vice versa.  You can also use this time as an opportunity to review your prescription drug plan to see whether a switch would be beneficial.  Before deciding to make a change its important to understand the differences between the two plans and why one might serve you better than the other.  Under traditional Medicare the government pays for your Medicare benefits directly insures you.  Medicare Advantage plans are offered by private companies and step in and take the place of your Medicare benefits.  Services in the Advantage plans are bundled.  Unlike traditional Medicare, if you are enrolled in an Advantage plan you are not eligible to purchase a Medigap policy.  Medigap policies are often purchased along with traditional Medicare to ensure that all health-related costs are covered.  One thing to make sure you are aware of when deciding as to whether an Advantage plan is right for you is to see whether, in the event of a hospitalization or stay in a rehab facility the Advantage plan will provide adequate coverage.  While the monthly out of pocket for the Advantage plan that you choose may be less, its important to be sure that you will be covered in the event of an illness that requires care outside of your normal day to day need.  One way to decide which plan is best for you is to go to Medicare’s website at www.medicare.gov and look for the Medicare Plan Finder tool.  This tool will help you to decide whether an Advantage plan or Traditional Medicare with a Part D Prescription plan is best for you.   Here you can plug in your pharmacy information, the drugs you take and can, in real time estimate your out of pocket costs under different plans.  Once you have done that it is also a good idea to contact the plan directly and confirm that the information is correct.

Nancy Burner, Esq.

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Burner Law Group, P.C.

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